Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • older age
  • asymptomatic
  • fatigue
  • bacterial infections
  • exercise intolerance
  • pallor
  • petechiae, purpura

Other diagnostic factors

  • autoimmune disorders
  • splenomegaly
  • hepatomegaly
  • lymphadenopathy

Risk factors

  • age >70 years
  • ionizing radiation
  • alkylating agents
  • topoisomerase inhibitors
  • prior hematopoietic stem cell transplantation
  • tobacco
  • benzene
  • aplastic anemia
  • paroxysmal nocturnal hemoglobinuria (PNH)
  • Down syndrome (trisomy 21)
  • congenital neutropenia
  • DNA repair deficiency syndromes

Diagnostic investigations

1st investigations to order

  • CBC with differential
  • reticulocyte count
  • red blood cell folate
  • serum B12 levels
  • iron studies
  • HIV testing
  • bone marrow aspiration with iron stain
  • bone marrow core biopsy
  • bone marrow cytogenetic analysis
Full details

Investigations to consider

  • serum erythropoietin
  • HLA typing
  • flow cytometry
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Staff Physician

VA Nebraska-Western Iowa Health Care System

Professor

Division of Oncology-Hematology

Department of Internal Medicine

University of Nebraska Medical Center

Omaha

NE

Disclosures

AKG has received research grants from Amgen, AstraZeneca, Bristol-Myers Squibb, Janssen, Merck, New Link Genetics, and Pfizer. AKG has been reimbursed for consulting work for Ariad Pharmaceuticals, Biodesix, and Pfeizer. He is also in discussion with Fresenius-Kabi on a consulting contract for clinical trial development. None of the grants or payments relate to work involving myelodysplastic syndrome.

Assistant Professor

Division of Oncology-Hematology

University of Nebraska Medical Center

Omaha

NE

Disclosures

AM declares that she has no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Medicine (Hematology) and Oncology

Division of Hematology

Department of Medicine

Mayo Clinic

Rochester

MN

Disclosures

DPS declares that he has no competing interests.

Professor of Haematology

Queen Mary University

London

UK

Disclosures

ACN declares that he has no competing interests.

Use of this content is subject to our disclaimer