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31st May 2023
A 78-year-old male with IPSS-R low risk myelodysplastic syndrome is reviewed in haematology clinic
A 78-year-old male with IPSS-R low risk myelodysplastic syndrome is reviewed in haematology clinic. He is being managed conservatively with transfusion support only currently. He is receiving two units of RBC every two weeks and has been doing so for 6 months now. He is managing well with this and remains asymptomatic.
His clinic bloods are as follows.
| Hb | 84 g/L | (130-180 g/L) | B12 | 300 pg/ml | (180-1000 pg/ml) |
| WCC | 2.8 x 10⁹/L | (3.6-11 x 10⁹/L) | Folate | 6.1 ng/ml | (>4 ng/ml) |
| Platelets | 68 x 10⁹/L | (150-400 x 10⁹/L) | Ferritin | 1250 ng/ml | (10-300 ng/ml) |
| Neutrophils | 1.1 x 10⁹/L | (1.8-7.5 x 10⁹/L) | |||
He also has a cardiac MRI which shows a shortened T2* relaxation time.
Which is the most appropriate next step?
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