A 69-year-old White woman was referred to our clinic for evaluation of pancytopenia.
She was found to have leukopenia (1.2 × 103/mm3) and thrombocytopenia (85 × 103/mm3) 6 months before her clinic visit, but did not receive further workup. She presented
with worsening fatigue, gingival bleeding and recurrent cellulitis of 3 months׳ duration.
Her blood counts at the time of clinic visit showed severe pancytopenia with white
blood cell count of 0.9 × 103/mm3, platelet count of 21 × 103/mm3 and hemoglobin of 8 g/dL. Peripheral smear showed macrocytosis and poikilocytosis but no blast forms.
Her initial coagulation studies were normal. She had undergone bone marrow biopsy
and aspiration by an outside hematologist 2 weeks before her clinic visit, which showed
a hypoplastic marrow (10-15% cellularity) without prominent morphologic features of
dyspoiesis. Flow cytometry analysis of the aspirate identified a regenerating myeloblast
population accounting for less than 1% of the analyzed events. Concurrent karyotype
analysis of the bone marrow aspirate revealed 46,XX,del(17)(q23)[4]/46,XX,del(1)(q32),del(17)(q23)[3]/46,XX[11]
identifying 2 clonal cell lines with del 17q present in both.
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Footnotes
☆The authors have no financial or other conflicts of interest to disclose.
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© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
