Case 124 – Update 2

Thank you for all of your input and suggestions. To summarise the case thus far:

  • 68 year old lady referred with a macrocytic anaemia and thrombocytosis:
    • Haemoglobin              87 g/L (115 – 165)
    • White cell count          5.2 x 109/L (4 – 11)
    • Platelets                      538 x 109/L (150 – 450)
    • Mean Cell Volume      108 fl (80 – 100)
  • No reversible cause identified on further investigation, and her blood film demonstrated some dysplastic features:


We therefore organised a bone marrow aspirate which confirmed trilineage dysplasia, no excess blasts and no excess ring sideroblasts:


Cytogenetics has subsequently confirmed a diagnosis of MDS with isolated del(5q) (like many of you suggested – good work!)


The patient comes back to clinic for results. How would you communicate her prognosis? What treatment options, if any, would you discuss?


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