High MDS white blood cells are not necessarily transleukemia. There are many causes of high MDS white blood cells, which can be roughly divided into two categories: physiological factors and pathological factors. 1. Physiological factors:emotional tension, emotional excitement, satiety, patients and menstruation may lead to high white blood cells. 2. Pathological factors: such as acute leukemia, most patients have increased white blood cell count. However, if MDS patients with decreased resistance may also cause bacterial infection leading to high white blood cell count. Some studies suggest that FAB typing, myelodysplasia, platelet count and chromosome analysis are important factors in predicting the transformation of MDS into leukemia, and continuous monitoring of the above indexes is conducive to the early prediction of the transformation of MDS into AL so as to guide the clinical use of medication, improve the efficacy of treatment and improve the prognosis. Thus, high leukocyte count in MDS is not an indicator of leukemia transformation. Patients with myelodysplastic syndromes (MDS) are advised to actively cooperate with their doctors, carry out treatments and follow-up monitoring to detect disease changes as early as possible. When the white blood cells are elevated, consult the doctor in time to identify the cause of the disease and give appropriate treatment under the doctor’s guidance.