Is it possible to have a normal white blood count, and end up diagnosed with myelodysplastic syndrome from a bone marrow biopsy?

Yes: It is a little confusing, but it is possible. We have 3 different cell lines in our blood: white blood cells, red blood cells and platelets or clotting cells. They all start their maturation in the marrow with young forms that evolve in mature, circulating cells. Myelodysplasia can affect 1, 2 or all cell lines and will eventually affect the number and/or the proportion of immature forms in blood