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Rapidly Progressing Myelodysplastic Syndrome Initially Presenting as Acute Leukemia

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ABSTRACT

Myelodysplastic syndrome (MDS) refers to a group of various stem cell disorders, characterized by dysplastic and ineffective production in one or more cell lines. In general, MDS tends to present slowly over months to years and is commonly detected with routine bloodwork by primary care physicians. Patients may be asymptomatic and depending on age, comorbidities and risk classification of MDS may not require aggressive therapy. However, MDS carries the risk of progressing to acute leukemia over time. We present a case of rapidly progressive MDS in a previously healthy middle-aged female, originally presenting and treated as acute leukemia.

No MeSH data available.


Related in: MedlinePlus

Monolobated megakaryocyte(1000X, Wright-Giemsa stain): Bone marrow aspiration smear shows monolobated megakaryocyte
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FIG1: Monolobated megakaryocyte(1000X, Wright-Giemsa stain): Bone marrow aspiration smear shows monolobated megakaryocyte

Mentions: A 56-year-old female with no significant past medical history presented to the emergency room (ER) after being sent by her primary care doctor for decreased hemoglobin and hematocrit on bloodwork. The patient had been experiencing fatigue, dizziness, palpitations and episodes of near syncope for the previous four-six weeks. Five months prior to presentation, her complete blood count was completely within normal limits, with a WBC of 5.3 th/mm3, hemoglobin of 12.2 g/dL, hematocrit of 37.6%, and platelets of 197 th/mm3. ER bloodwork showed WBC of 4 th/mm3, hemoglobin of 6.9 g/dL, hematocrit of 21%, and platelets of 27 th/mm3. The patient was subsequently transfused with two units of packed red blood cells (PRBC). The results of the post-transfusion bloodwork were WBC of 5.6 th/mm3, hemoglobin of 8.6 g/dL, hematocrit of 26.1%, and platelets of 28 th/mm3. At that time, computed tomography (CT) of chest, abdomen, and pelvis was performed and did not reveal any clinically significant abnormalities. The patient was evaluated by a hematologist/oncologist, and bone marrow biopsy and flow cytometry were subsequently done (Figures 1-2).


Rapidly Progressing Myelodysplastic Syndrome Initially Presenting as Acute Leukemia
Monolobated megakaryocyte(1000X, Wright-Giemsa stain): Bone marrow aspiration smear shows monolobated megakaryocyte
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5392037&req=5

FIG1: Monolobated megakaryocyte(1000X, Wright-Giemsa stain): Bone marrow aspiration smear shows monolobated megakaryocyte
Mentions: A 56-year-old female with no significant past medical history presented to the emergency room (ER) after being sent by her primary care doctor for decreased hemoglobin and hematocrit on bloodwork. The patient had been experiencing fatigue, dizziness, palpitations and episodes of near syncope for the previous four-six weeks. Five months prior to presentation, her complete blood count was completely within normal limits, with a WBC of 5.3 th/mm3, hemoglobin of 12.2 g/dL, hematocrit of 37.6%, and platelets of 197 th/mm3. ER bloodwork showed WBC of 4 th/mm3, hemoglobin of 6.9 g/dL, hematocrit of 21%, and platelets of 27 th/mm3. The patient was subsequently transfused with two units of packed red blood cells (PRBC). The results of the post-transfusion bloodwork were WBC of 5.6 th/mm3, hemoglobin of 8.6 g/dL, hematocrit of 26.1%, and platelets of 28 th/mm3. At that time, computed tomography (CT) of chest, abdomen, and pelvis was performed and did not reveal any clinically significant abnormalities. The patient was evaluated by a hematologist/oncologist, and bone marrow biopsy and flow cytometry were subsequently done (Figures 1-2).

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Myelodysplastic syndrome (MDS) refers to a group of various stem cell disorders, characterized by dysplastic and ineffective production in one or more cell lines. In general, MDS tends to present slowly over months to years and is commonly detected with routine bloodwork by primary care physicians. Patients may be asymptomatic and depending on age, comorbidities and risk classification of MDS may not require aggressive therapy. However, MDS carries the risk of progressing to acute leukemia over time. We present a case of rapidly progressive MDS in a previously healthy middle-aged female, originally presenting and treated as acute leukemia.

No MeSH data available.


Related in: MedlinePlus