25th July 2024

A 70-year-old lady presents to A&E with epistaxis ongoing for more than one hour

A 70-year-old lady presents to A&E with epistaxis ongoing for more than one hour. She describes a history of significant fatigue and dyspnoea. Her full blood count shows a pancytopenia, and you suspect a diagnosis of acute myeloid leukaemia.

She has a background of myelodysplastic syndrome and breast cancer in remission, previously treated surgically, alongside radiotherapy and chemotherapy (docetaxel and cyclophosphamide).

Which of these is NOT a likely risk factor for her development of AML?

Select the SINGLE most appropriate option from the list below. Select ONE option only.