title: Refractory anemia with ring sideroblasts associated with marked thrombocytosis complicated by massive splenomegaly treated with lenalidomide resulting in resolution of splenomegaly but severe and prolonged pancytopenia.
abstract: Refractory anemia with ring sideroblasts associated with marked thrombocytosis (RARS-T) is a hematological malignancy that combines features of both a myeloproliferative and myelodysplastic disorder. There have been recent reports of the successful treatment of anemia in 2 patients with RARS-T with lenalidomide. Here we report the successful treatment of massive splenomegaly in a patient with a long history of RARS-T resulting in complete resolution of splenomegaly, but with prolonged severe cytopenias. We also report the acquisition of the t(3;12)(q26;p13) translocation previously described in cases of myelodysplasia and the potential for transformation to myelofibrosis.
authors: Department of Haematology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK.
authors: Gordon
authors: G
authors: Taylor
authors: Dominic
authors: D
authors: Culligan
authors: Mark A
authors: MA
authors: Vickers
references: N Engl J Med. 2005 Feb 10;352(6):549-57
references: 15703420
references: Leukemia. 2012 Mar;26(3):542-5
references: 21886174
references: Blood. 2010 Nov 25;116(22):4436-8
references: 20651074
references: Blood. 2012 Jan 12;119(2):569-72
references: 22096241
references: Blood. 2010 Jul 15;116(2):180-2
references: 20194893
references: N Engl J Med. 2010 Sep 16;363(12):1117-27
references: 20843246
references: Br J Haematol. 2002 May;117(2):288-96
references: 11972510
references: J Clin Oncol. 2009 Sep 20;27(27):4563-9
references: 19652059
references: N Engl J Med. 2006 Oct 5;355(14):1456-65
references: 17021321
references: Haematologica. 2010 Mar;95(3):518-9
references: 19903679
references: Leukemia. 2006 Sep;20(9):1641-4
references: 16871284