TY  - CHAP
M1  - Book, Section
TI  - Low-risk myelodysplastic syndrome
A1  - Smith, Graeme
PY  - 2018
T2  - Problem Solving in Haematology
AB  - A  70-year-old  otherwise  fit  and  healthy  female  had  been  diagnosed  3  years  previously  with  myelodysplastic  syndrome  (MDS;  French–American–British  [FAB]  classification  subtype  refractory  anaemia).  Cytogenetic  analysis  was  not  done,  as  it  was  considered  unnecessary  in  this  age  group.  The  patient  had  a  haemoglobin  concentration  of  7.5  g/dl,  white  cell  count  4  ×  109/l,  neutrophils  2.4  ×  109/l  and  platelets  450  ×  109/l  at  diagnosis.  Red  cell-transfusion  therapy  was  commenced,  with  a  transfusion  interval  of  3  weekly,  to  temporarily  relieve  symptoms  of  anaemia.  A  trial  of  recombinant  human  erythropoietin  therapy  with  30  000  units  per  week  for  6  weeks,  escalating  to  60  000  units  per  week  for  6  weeks,  produced  no  erythroid  response.  Serum  ferritin  assayed  after  3  years  of  red  cell-transfusion  dependence  was  4500  mg/l.  A  bone  marrow  examination  was  repeated  to  confirm  disease  stability  with  a  view  to  commencing  iron-chelation  therapy.  Serum  erythropoietin  concentration  was  2000  IU/l.  The  morphology  confirmed  World  Health  Organization  (WHO)  classification  subtype  refractory  cytopenia  with  multilineage  dysplasia,  which  was  changed  to  a  diagnosis  of  5q-  syndrome  when  cytogenetic  analysis  revealed  all  20  metaphases  showing  del(5)(q13-33)  as  the  sole  abnormality.Should  a  trial  of  recombinant  erythropoietin  have  been  offered?Is  there  a  therapeutic  option  to  modify  disease  and  promote  erythropoiesis?  
SN  - 
PB  - Clinical Publishing Oxford
CY  - New York, NY
Y2  - 2021/03/08
UR  - hemonc.mhmedical.com/content.aspx?aid=1152482488
ER  -