低危骨髓增生异常综合征患者接受红细胞生成刺激剂治疗 10 年的管理。
Low-risk myelodysplastic syndrome managed with an erythroid-stimulating agent for 10 years.
机构信息
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
出版信息
BMJ Case Rep. 2020 Apr 6;13(4):e232285. doi: 10.1136/bcr-2019-232285.
A 57-year-old man with a history of diabetes and coronary artery disease was referred to haematology for the evaluation of anaemia in the setting of non-cardiac chest pain, fatigue, dyspnoea and dizziness. Previous investigations into these recurrent symptoms focused on a re-evaluation of his known ischaemic heart disease, which required multiple percutaneous interventions with stenting several years ago. In the year leading up to his referral, the patient required two transfusions during separate hospitalisations. Previously, his chronic anaemia was attributed to chronic inflammation because of unrevealing micronutrient and endoscopic evaluations. The patient underwent a bone marrow biopsy, which demonstrated normal karyotype myelodysplastic syndrome with ringed sideroblasts. This patient was found to have favourable cytogenetics and low-risk disease. His anaemia and associated symptoms improved with the administration of an erythroid-stimulating agent. Now 75 years old, he has remained on single-agent therapy for 10 years without need of transfusion.
一位 57 岁男性，有糖尿病和冠状动脉疾病病史，因非心前区胸痛、乏力、呼吸困难和头晕就诊于血液科，以评估贫血。以前对这些反复发作的症状的检查主要集中在重新评估他已知的缺血性心脏病，这需要几年前进行多次经皮介入和支架置入。在他被转介之前的一年里，患者在两次不同的住院期间需要输血。以前，由于微营养素和内窥镜检查没有发现异常，他的慢性贫血归因于慢性炎症。患者进行了骨髓活检，显示正常核型骨髓增生异常综合征伴环形铁幼粒细胞。该患者被发现具有有利的细胞遗传学和低危疾病。他的贫血和相关症状在给予促红细胞生成剂后得到改善。现在他 75 岁了，已经接受单一药物治疗 10 年，无需输血。
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