Evidence-based mini-review: Should patients over the age of 60 with INT-2 or high-risk myelodysplastic syndrome undergo allogeneic stem cell transplantation prior to progression to acute myelogenous leukemia?
A 65-year-old male who was previously in good health presented to his primary care physician with increasing fatigue over several months. He was found to be anemic (hemoglobin 7.5 mg/dL) and neutropenic (absolute neutrophil count 1000/μL). Further laboratory investigation showed an elevated erythropoietin level and normal iron stores. Bone marrow biopsy revealed dysplasia in two lineages and 8% blasts. Cytogenetic studies showed a clone with loss of 7q. He required red blood cell transfusions approximately every 2 weeks. He was started on hypomethylating agent treatment and referred for consultation regarding the role of hematopoietic stem cell transplantation. HLA typing results demonstrated that he had an HLA-identical sibling.
Washington University Medical School, St. Louis, MO 63110, USA. mschroed@dom.wustl.edu
Mark A
MA
Schroeder
William
W
Blum
D000368:Aged; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology*; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous
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