Hemodynamic management of a patient with unclassified myelodysplastic neoplasm: a clinical case report
DOI:
https://doi.org/10.55204/trc.v6i2.e715Keywords:
Myelodysplastic neoplasms, Hemodynamic management, Clinical case, Severe anemia, Hematological nursingAbstract
Unclassified myelodysplastic and myeloproliferative diseases constitute a rare group of hematologic malignancies characterized by ineffective hematopoiesis and abnormal cell proliferation in the bone marrow. This causes severe anemia, leukocytosis, or thrombocytopenia, leading to a high risk of hemodynamic decompensation and infections. Objective: To describe the clinical and hemodynamic management of a 58-year-old patient diagnosed with unclassified myelodysplastic and myeloproliferative neoplasm in a second-level hospital. A 58-year-old male patient with a history of essential thrombocythemia and chronic anemic syndrome who was admitted to the emergency department presenting extreme asthenia, dynamia, and atypical chest pain due to hypoxia, with a critical hemoglobin of 6.0 g/dL and leukocytosis of 81,900 /μL. Immediate hemodynamic stabilization was performed using oxygen therapy, fluid therapy, and transfusion of two globular packs. After acute coronary ischemic involvement was ruled out and the definitive diagnosis was confirmed (ICD-10: C94.6), the patient began chemotherapy with azacitidine, therapy with erythropoietin, and prophylaxis of tumor lysis syndrome with allopurinol. It concluded that timely intervention through transfusion support, continuous cardiovascular monitoring, and prevention of complications such as tumor lysis syndrome and myelosuppression are essential for the survival and stability of patients with refractory bone marrow failure.Downloads
References
1. Fontana D, Elli EM, Pagni F, Piazza R. Myelodysplastic Syndromes/Myeloproliferative Overlap Neoplasms and Differential Diagnosis in the WHO and ICC 2022 Era: A Focused Review. Cancers (Basel). 2023 Jun 13;15(12):3175. doi:10.3390/cancers15123175
2. Gerke MB, Christodoulou I, Karantanos T. Definitions, Biology, and Current Therapeutic Landscape of Myelodysplastic/Myeloproliferative Neoplasms. Cancers (Basel). 2023 Jul 27;15(15):3815. doi:10.3390/cancers15153815
3. Khoury JD, Solary E, Abla O, Akkari Y, Alaggio R, Apperley JF, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia. 2022 Jul 22;36(7):1703–19. doi:10.1038/s41375-022-01613-1
4. Pinto VM, Romano N, Balocco M, Carrara P, Lamagna M, Quintino S, et al. Reduction of extramedullary erythropoiesis and amelioration of anemia in a β‐thalassemia patient treated with thalidomide. Am J Hematol. 2024 Mar 26;99(3):463–4. doi:10.1002/ajh.27189
5. Aspa-Cilleruelo JM, de Hontanar Torres GL, Gómez MM, Mazo EM. Neoplasias mieloproliferativas crónicas. Clasificación. Leucemia mieloide crónica. Medicine - Programa de Formación Médica Continuada Acreditado. 2024 Nov;14(20):1149–56. doi:10.1016/j.med.2024.10.019
6. Martinez-Cibrian N, Zeiser R, Perez-Simon JA. Graft-versus-host disease prophylaxis: Pathophysiology-based review on current approaches and future directions. Blood Rev. 2021 Jul;48:100792. doi:10.1016/j.blre.2020.100792
7. Hasserjian RP, Germing U, Malcovati L. Diagnosis and classification of myelodysplastic syndromes. Blood. 2023 Dec 28;142(26):2247–57. doi:10.1182/blood.2023020078
8. DeZern AE, Greenberg PL. The trajectory of prognostication and risk stratification for patients with myelodysplastic syndromes. Blood. 2023 Dec 28;142(26):2258–67. doi:10.1182/blood.2023020081
9. Cardos Gómez V, Vázquez Martínez C. Protocolo diagnóstico de la trombocitosis. Medicine - Programa de Formación Médica Continuada Acreditado. 2024 Nov;14(20):1204–8. doi:10.1016/j.med.2024.10.025
10. Godfrey AL, Green AC, Harrison CN. Essential thrombocythemia: challenges in clinical practice and future prospects. Blood. 2023 Apr 20;141(16):1943–53. doi:10.1182/blood.2022017625
11. Arana-Luna LL, Alvarado-Ibarra M, Silva-Michel LG, Morales-Maravilla A, González-Rubio M del C, Chávez-Aguilar LA, et al. Consenso de leucemia mieloide aguda en México. Gac Med Mex. 2023 Mar 28;158(73). doi:10.24875/GMM.M21000597
12. Mann DL, Schafer AI. Cardio-Hematopoietic Axis in Cardiac Injury and Repair: From Adaptation to Maladaptation. Arterioscler Thromb Vasc Biol. 2026 Jan;46(1):85–96. doi:10.1161/ATVBAHA.125.323168
13. McCallinhart PE, Chade AR, Bender SB, Trask AJ. Expanding landscape of coronary microvascular disease in co-morbid conditions: Metabolic disease and beyond. J Mol Cell Cardiol. 2024 Jul;192:26–35. doi:10.1016/j.yjmcc.2024.05.004
14. Tune JD, Goodwill AG, Kiel AM, Baker HE, Bender SB, Merkus D, et al. Disentangling the Gordian knot of local metabolic control of coronary blood flow. American Journal of Physiology-Heart and Circulatory Physiology. 2020 Jan 1;318(1):H11–24. doi:10.1152/ajpheart.00325.2019
15. Han D, Rozanski A, Gransar H, Sharir T, Einstein AJ, Fish MB, et al. Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes: Results From the Multicenter International REFINE SPECT Registry. Diabetes Care. 2020 Feb 1;43(2):453–9. doi:10.2337/dc19-1360
16. AlBadri A, Wei J, Quesada O, Mehta PK, Xiao Y, Ko YA, et al. Coronary Vascular Function and Cardiomyocyte Injury. Arterioscler Thromb Vasc Biol. 2020 Dec;40(12):3015–21. doi:10.1161/ATVBAHA.120.314260
17. Paolisso P, Gallinoro E, Belmonte M, Bertolone DT, Bermpeis K, De Colle C, et al. Coronary Microvascular Dysfunction in Patients With Heart Failure: Characterization of Patterns in HFrEF Versus HFpEF. Circ Heart Fail. 2024 Jan;17(1). doi:10.1161/CIRCHEARTFAILURE.123.010805
18. Aljizeeri A, Ahmed AI, Suliman I, Alfaris MA, Elneama A, Al-Mallah MH. Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus. Eur Heart J Cardiovasc Imaging. 2023 Apr 24;24(5):563–71. doi:10.1093/ehjci/jead023
19. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Eur J Heart Fail. 2022 Jan 1;24(1):4–131. doi:10.1002/ejhf.2333
20. Chavez-Santiago WG, Martínez-Arias LO, Quintero-Barriga GC, Latorre-Núñez Y, Ovalle Torres SA, Robles-Casibanay AA, et al. Tratamiento de la falla cardiaca con fracción de eyección preservada. Acta Médica Colombiana. 2022 May 16;47(3). doi:10.36104/amc.2022.2110
21. Chavez-Santiago WG, Martínez-Arias LO, Quintero-Barriga GC, Latorre-Núñez Y, Ovalle Torres SA, Robles-Casibanay AA, et al. Tratamiento de la falla cardiaca con fracción de eyección preservada. Acta Médica Colombiana. 2022 May 16;47(3). doi:10.36104/amc.2022.2110
22. Sánchez-Alfaro LA, Gómez Henao J. Principios bioéticos y virtudes éticas en la toma de decisiones fisioterapéuticas en una unidad de cuidado intensivo (UCI) de Bogotá. Rev Latinoam Bioet. 2022 Dec 27;22(2):99–111. doi:10.18359/rlbi.5920
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