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Topics:
Hematologic Malignancies • Medical Oncology • Myelodysplastic Syndromes • Internal Medicine • Hematology
How do you approach severe anemia and thrombocytopenia in an elderly patient whose bone marrow biopsy shows hypercellular marrow with mild dysplasia in erythroid and megakaryocytic lineage but normal cytogenetics and a negative NGS panel?
Hgb is 8 and platelets 10. A very small PNH clone (0.08%) detected. No evidence of hemolysis. No response to steroids. All other anemia/thrombocytopenia workup negative.
Answer from: Medical Oncologist at Community Practice
This is a really interesting case! Few things to consider:
The presence of a small PNH clone suggests marrow injury however the marrow is usually hypo rather than hypercellular in this scenario. It may be worthwhile to send HLA typing. The presence of HLA-B14:02, HLA-B40:02, and HLA-B07:02 a...
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