Myelodysplastic neoplasia (MDS) is a group of stem cell disorders involving ineffective hematopoiesis. It can be associated with an increased risk progression toward acute myeloid leukemia (AML). In Bahrain, MDS the fifth most common primary hematologic malignancy. has annual incidence up to 4 million cases. Some presenting signs and symptoms are often nonspecific, such as fatigue, pallor, mala...