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You have a patient with chronic pancytopenia due to myelodysplasia attending the day unit because of temperatures. She is 69 years old and has suffered from myelodysplasia for the past 7 years. Myelodysplasia is a malignant clonal stem cell disorder characterised by dysplastic changes on bone marrow examination and results in ineffective haematopoiesis causing varying degrees of panctopenia. Her normal full blood count approximately: Hb 90g/L, platelets 100×10*9/L and neutrophils 0.9×10*9/L. Her haemoglobin is supported by a transfusion programme, with approximately 2 units of packed red cells every two months.
- What is your approach in this patient?
- Are you concerned?
- Any investigations?
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