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The myelodysplastic syndromes (MDS) are acquired bone marrow disorders characterized by therapy-resistant cytopenias as a result of ineffective hematopoiesis and by preleukemic states. Diagnosis of MDS is done by clinical manifestations and hematological findings mainly according to the 4th WHO classification, but as it is sometimes difficult to discriminate MDS from other hematological diseases, a guideline for morphological evaluation is proposed. International Prognostic Scoring System is useful for choice of the treatment but this system is now under revision. Although most patients are fatal except the cases who receive successful stem cell transplantation, promising therapeutic drugs such as DNA hypomethylating agents and lenalidomide are developed and may alter the prognosis and quality of life of the patients suffering from MDS.

The frequency of anemia in Japan is statistically higher than that of foreign countries. Especially, Japanese females frequently fall ill with iron deficiency anemia(IDA) because of decreased intake of iron. Secondary anemia is of the second-highest frequency. While primary hematological disorders account for only a small fraction of whole anemic patients, aplastic anemia is relatively frequent in the world-wide statistics. The frequency of myelodysplastic syndromes is now increasing with aging of the population. It is important to sustain our effort in assembling the data as to the prevalence of anemia.