What lab abnormalities will you normally see in a newly diagnosed myelodysplastic syndromes patient?

What lab abnormalities will you normally see in a newly diagnosed MDS patient? A person with myelodysplastic syndrome most commonly has anemia. We will refer to a lab test called a hemoglobin and if that's below normal we will say to somebody you have anemia. Now most people who have mild anemia don't really feel it. But once a hemoglobin drops below a level of 10 grams per deciliter, certainly below 9 or 8 grams per deciliter, people sometimes start to have symptoms from that. Those symptoms may be fatigue, shortness of breath, lack of appetite, even sometimes some fuzzy thinking. Other symptoms someone will have are associated with a low platelet count. Normal platelet count is over 150,000. When a platelet count drops below 100,000 someone may never feel it. Once it drops below 50,000 if that person experiences trauma, for example falling and hitting her head, that person may have excess bleeding. And certainly once a platelet count drops below 20,000 that person is more prone to excess bleeding, certainly bruising and difficulty healing even minor cuts. Most of the time in newly diagnosed MDS patients we see low blood counts and that can be low neutrophils, low hemoglobin or platelets. And because as I mentioned previously, stem cells are being affected and stem cells need to be healthy in order for them to grow and become healthy neutrophils, red blood cells or platelets. When patients are diagnosed, they generally present either with infection because their neutrophil counts are low or present with bleeding complications if they have low platelets. And therefore it is important actually to check their complete blood counts to determine if they have any abnormalities in these blood counts. Actually if a patient presents with low blood counts, so then that's when you suspect that they can have myelodysplastic syndrome. And subsequently you would like to proceed with bone marrow biopsy to better assessment where that low blood count can be coming from. Unless you perform bone marrow biopsy, you will not have the full picture of what's going on with the patient. If we perform next generation sequencing for example, that can give us some hint about any molecular abnormalities, but wouldn't necessarily tell us if this patient for example has myelodysplastic syndrome or maybe acute leukemia. Or in some cases actually if patients don't have necessarily mutational abnormalities, that doesn't rule out completely myelodysplastic syndrome. And we want to know if they have MDAs versus they have a plastic anemia or any other diseases in which cases the blood counts can be affected. In bone marrow biopsy also you look for like these plastic changes or abnormalities, blood counts look like. And also we want to perform chromosome testing. And for chromosomal analysis it is best for it to be done using bone marrow sample because myelodysplastic syndrome patients most of the time will have low blood counts and you can't necessarily perform good chromosome analysis unless you go directly to bone marrow for a sample for assessment.