What are the key diagnostic criteria for myelodysplastic syndromes (MDS) in primary care?

In primary care, there are no specific diagnostic criteria for myelodysplastic syndromes (MDS) that are applied to definitively diagnose the condition ¹. The definitive diagnosis of myelodysplastic syndromes, like other haematological cancers, is undertaken by specialist integrated haematological malignancy diagnostic services (SIHMDS) and managed by a haemato-oncology multidisciplinary team (MDT) ¹. These specialist services use the current World Health Organization (WHO) classification for diagnosis and sub-typing ¹.

The key role of primary care is to recognise general symptoms that may indicate a haematological malignancy and prompt appropriate initial investigations and referral ¹. For adults, symptoms such as unexplained bruising, pallor, unexplained petechiae, persistent fatigue, unexplained fever, unexplained persistent or recurrent infection, generalized lymphadenopathy, unexplained bleeding, or hepatosplenomegaly should prompt consideration of a very urgent full blood count (within 48 hours) ³,⁵. While these symptoms are specifically listed as indicators for leukaemia, they represent general haematological red flags that would necessitate further investigation and potential referral to secondary care for any suspected haematological cancer, including MDS ³,⁵,¹.

Clinicians in primary care are advised to refer any patient with suspected haematological cancer to an appropriate haemato-oncology MDT ¹. Written referral policies are disseminated to primary care teams to promote prompt and appropriate referral ¹.