Francisb,
As I understand it, having a high MPV and a low platelet count indicates that a large percentage your platelets are new (recently released from the bone marrow). That implies that they aren't lasting long enough. These counts are useful to make a diagnosis, but since you already have a diagnosis I think what's important is to decide how your high-risk MDS should be treated.
I should also point out that diabetes is associated with a higher MPV, and that may in part explain your results. See
this research report, for example.
Of the counts you mention, I think your blast count is the most important one. Medical researchers have drawn an arbitrary line at 20% blasts for classification and statistical purposes, but there's really little difference between 19% and 20% blasts. Treatment may be warranted either way. So the blast count found in your next bone marrow biopsy will be important, to find out what direction your blast count is headed.
I suggest that you request the
MDS information packet from the Aplastic Anemia & MDS International Foundation, and that you check out the
Bone Marrow Handbook and Frequently Asked Questions at the MDS Foundation website.