Myelodysplastic syndrome forms a part of the spectrum in the process of transformation to acute leukemia. It becomes important to identify factors which can shift the balance towards acute leukemia. So, what is new? There are already a good number of prognostic factors standardized by WHO. What is less realized is this process of standardization is an ongoing one. In the present study we found three factors which had a poor prognosis. We did an in-depth study covering the clinical and morphological profile of 30 cases and the cytogenetics profile of 13/30 cases of MDS over a period of 5 years. In the present study we found 3 factors which were associated with poor survival and include polymorphic variant of chromosome 9, CD34 positive megakaryocytes in the bone marrow biopsy, and eosinophils with basophilic granules. There are occasional articles on high-level of CD34 expression on megakaryocytes associated with adverse outcome (223), but there is no literature on polymorphic variant of chromosome 9 and eosinophils with basophilic granules in association with MDS. We intend to ignite an interest on this and add to the literature.