Macrocytosis Case
Jefferson Medical College of Thomas Jefferson University
http://www.hematology.org/education/teach_case/besa/Our purpose is to provide standardized peer-reviewed virtual cases for teaching Hematology to second year medical students and to assist course directors as a resource for use in their medical school. A 78 year-old woman presents with macrocytosis and fatigue. The case is developed from the early stage of the disease (and the work-up for cause of macrocytosis) and includes a teaching of megaloblastic and nonmegaloblastic causes for macrocytosis. The case then follows a diagnosed patient with early stage myelodysplastic syndrome which progresses into acute leukemia. New classifications and staging of the disease is addressed.
The learner will be able to: 1. Work up a macrocytic anemia and the differential 2. Learn that macrocytosis is common in patients with MDS but not universal 3. Differentiate a macrocytic anemia between a megaloblastic and nonmegaloblastic condition 4. Learn that MDS is a stem cell abnormality with two different mechanisms for the cytopenia 5. Know the role of hematopoietic growth factors in hematopoiesis and preventing excess apoptosis in the BM precursor cells 6. Evaluate an MDS patient for prognosis and risk for transformation to AML 7. Evaluate response to treatment 8. Learn that there is no standard therapy for this disease and the important role of clinical trial for patient with good performance status