The Significance of Peripheral Blood Cell Parameters and Bone Marrow Morphology Testing in the Differential Diagnosis of Megaloblastic Anemia and Myelodysplastic Syndrome

Cheng Linlin; Lei Ningjing; Zhang Xiaodong

doi:10.3969/j.issn.1004-5775.2026.03.016

Abstract：Objective:To explore the differential diagnosis of peripheral blood cell parameters and bone marrow morphological examination between megaloblastic anemia(MA)and myelodysplastic syndrome(MDS).Methods:It selected 45 MDS patients and 45 MA patients admitted to the First People's Hospital of Nanyang City from February 2022 to February 2024 as the subjects.Automated hematology analyzer Sysmex XN-2800 was used to measure the blood routine indexes of different patients,such as mean red blood cell volume(MCV),red blood cell count(RBC),platelet count(PLT),red blood cell distribution width standard deviation(RDW-SD),hemoglobin concentration(Hb),white blood cell count(WBC)and mean hemoglobin concentration(MCH).At the same time,the morphological examination techniques of peripheral blood cells and bone marrow were analyzed,and the differences in morphological characteristics between the two groups were analyzed.Results:There was no significant difference in hematological indexes,such as WBC,RBC,Hb,PLT and MCV between the two groups(P＞0.05).The levels of MCH and RDW-SD in MA group were significantly higher than those in MDS group.Morphological examination of bone marrow showed that the proportion of primordial cells was≥5.0%,and the incidence of granulocyte abnormality,erythroid abnormality and small megakaryocyte in MDS group was higher than that in MA group,with statistical significant differences(P＜0.05).The proportion of macroprimitive red blood cells and megaloblastic red blood cells in MDS group was significantly lower than that in MA group,the PAS positive rate of nucleated red blood cells in MDS group was significantly higher than that in control group,and the differences were statistically significant(P＜0.05).Conclusion:The use of peripheral blood cell parameters and bone marrow morphology testing techniques for differential diagnosis of MA and MDS has high value and can be applied.