Mrs. Zhang is 62 years old and has been suffering from “aplastic anemia”, but did not pay much attention to it, only regular blood transfusions and medication at the hospital for many years. But a few days ago, after a blood test at the hospital, the doctor asked her to do a bone marrow aspiration and bone marrow biopsy. The doctor said that she was not suffering from a reoccurrence, but from a disease called “myelodysplastic syndrome”. The doctor also said that the disease might turn into other diseases in the future. Mrs. Zhang asked the doctor if the previous diagnosis of “aplastic anemia” was wrong. The doctor said that the previous diagnosis was also correct, but the disease had changed, from one to another. The doctor also said that this is not uncommon in blood diseases. Many people have the idea that if you have one disease, it’s always that disease, such as high blood pressure or diabetes, and it doesn’t turn into something else. This notion is usually true, but as a doctor, especially a hematologist, you can’t think that way. The human body is a complex system, many blood system diseases in the early stage can be manifested as one disease, but in the process of treatment may gradually transform into another disease, and the treatment and prognosis of these two diseases are very different. Like Mrs. Zhang, the transformation from “aplastic anemia” to “myelodysplastic syndrome” is actually very common. There are also cases of transformation from aplastic anemia to leukemia, dystrophic anemia to myelodysplastic syndrome, myelodysplastic syndrome to acute leukemia, true erythrocytosis to leukemia, and primary thrombocythemia to myelofibrosis. The reason for this is that these diseases are caused by lesions in the “progenitor” of human hematopoietic cells, the hematopoietic stem cells, and in many of their “offspring” cells. As a result, they show complex and variable clinical signs, behaving as one disease at one stage and as another at another. The time of the patient’s visit varies, as do the manifestations of the disease, and the doctor’s diagnosis may vary. This is when a review becomes necessary. Therefore, the majority of patients with blood disorders must eliminate misunderstandings and visit the hospital regularly for diagnosis and treatment with the help of a specialist, rather than not going to the hospital for many years for checkups, so as not to delay their condition.