Skill Checkup: A 72-Year-Old Woman With Myelodysplastic Syndrome Presents With Persistent Anemia and Fatigue

Emmanuel C. Besa, MD


April 08, 2022

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 72-year-old woman presents with persistent anemia and fatigue. Her height is 5 ft 2 in and weight is 131 lb (body mass index of 24). She was diagnosed with low- to intermediate-risk myelodysplastic syndrome (MDS) with ring sideroblasts 2 years ago, when she presented with a hemoglobin of 10.9 g/dL. Bone marrow biopsy at the time showed blasts were 5%-7% and she had a normal female karyotype. She tested positive for SF3B1 mutation and negative for JAK2 V617F mutation. The patient received erythropoiesis-stimulating agent (ESA) therapy and required ≥ 2 red blood cell (RBC) units over 8 weeks. However, despite ESA therapy, the patient presents with symptomatic anemia; her hemoglobin is 10.1 g/dL. There are no blasts in the blood; 16% of erythroid precursors with ring sideroblasts are identified.


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