• PDF / 171,066 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 65 Downloads / 165 Views

DOWNLOAD

REPORT

---

1

S

Therapy-related myelodysplastic syndrome: case report A 60-year-old man developed therapy-related myelodysplastic syndrome (t-MDS) during treatment with mitomycin and unspecified highly active antiretroviral therapy (HAART). The man presented with a 2-week history of worsening fatigue. He had ongoing HIV and AIDS related complications, including cryptococcal meningitis. Six years prior to the presentation, he had been diagnosed with invasive anal squamous cell carcinoma, and had been receiving mitomycin [dosage and route not stated] and radiation therapy. He was additionally receiving HAART for HIV [specific drugs not stated]. His latest CD4 T cell count was 299 /µL. A peripheral blood smear demonstrated pancytopenia. Complete blood count showed the following: WBC 2.91×109/L, neutrophils 34%, lymphocytes 61%, eosinophils 1%, monocytes 4%, basophils 0%, RBC 2.81 × 1012/L, Hb 7.2 g/dL, haematocrit 22.5%, mean corpuscular volume 80.1Fl and platelet count 14 × 109/L. A bone marrow biopsy revealed hyper-cellular marrow, with left-shifted granulopoiesis, clusters of blasts, megakaryocytic and erythroid dysplasia. An immunostaining of CD34 demonstrated interstitially increased clusters of blasts. A flow cytometry showed 58% maturing granulocytic elements with decreased orthogonal light scatter properties (suggestive of hypogranularity) with an unusual maturation spectrum, and an increased distinct myeloblasts population with immunophenotypical aberrancy. A cytogenetic analysis showed complex karyotype of multiple chromosomal abnormalities. Based on the findings, he was diagnosed with tMDS [time to reaction onset not stated]. The man was treated with azacitidine. However, he developed progressive pancytopenia. Three months later, he died [outcome of reaction and cause of death not stated]. Author comment: "The incidence of therapy-related myelodysplastic syndromes (t-MDS) has been increasing with the widespread use of highly active antiretroviral therapy (HAART) therapy for HIV and chemotherapy for AIDS-related cancers." Shi M, et al. Evolving myelodysplastic syndrome in an HIV patient with history of anal cancer and chemotherapy. Journal of Hematopathology 12: 213-214, No. 4, Dec 2019. Available from: URL: http://doi.org/10.1007/s12308-019-00373-9 803443131 USA

0114-9954/20/1785-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 4 Jan 2020 No. 1785