Impending relapse of myelodysplastic syndrome after allogeneic transplant is difficult to diagnose and requires a multi-modal approach.

There was a significant difference between the pre-transplant and relapse platelet count [pre-transplant median of 73 × 10 9 /L (range 5–1242) and relapse median 38 × 10 9 /L (range 7–189), p = 0.028] and a borderline significant difference between the pre-transplant and relapse white blood cell count [pre-transplant median 3.3 × 10 9 /L (1–33 range) and relapse median 2.5 × 10 9 /L (0.6–7.6 range) p = 0.054].

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