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Case report
Low-risk myelodysplastic syndrome managed with an erythroid-stimulating agent for 10 years
  1. Anthony Esparza1,
  2. Raj Chandra Singaraju1,2 and
  3. Joseph Paul Happel2
  1. 1Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  2. 2Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  1. Correspondence to Dr Raj Chandra Singaraju; raj.singaraju{at}


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.

  • long term care
  • malignant and benign haematology
  • medical management

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  • Contributors AE treated the patient in clinic. AE drafted the case report and RCS and JPH revised the draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.