Thank you for your ongoing care of Sarah, whom I reviewed regarding pancytopenia and further investigation of her bone marrow biopsy results. Sarah presented today for a follow-up appointment to discuss the results of her bone marrow biopsy and subsequent investigations. She reports feeling fatigued but denies any new bleeding or bruising. Her weight has remained stable. On examination, she appears well, with no new lymphadenopathy or hepatosplenomegaly. Her blood counts remain low, but stable.
**Investigations:**
**SA Path 01/11/2024:**
Hb 95 g/L
WCC 2.5 x10^9/L
LC 1.0 x10^9/L
PLT 50 x10^9/L
Biochem NAD
Igs all NAD
PP 0
SFLC ratio normal
EBV and CMV not detected
Hep B, Hep C and HIV not detected
**Clinpath 25/10/2024:**
Hb 98 g/L
MCV 85 fL
WCC 2.7 x10^9/L
LC 1.2 x10^9/L
PLT 52 x10^9/L
Biochem NAD
Igs all NAD
B12 normal
Iron studies normal
Urine culture no growth
ESR 15 mm/hr
CRP 2 mg/L
HbA1c 38 mmol/mol
TFTs NAD
Lipid profile normal
PSA NAD
**Impression:**
- Pancytopenia, stable, likely secondary to myelodysplastic syndrome (MDS).
- No other significant findings.
**Deferred Treatments:**
No immediate treatment is planned at this time. We will continue to monitor her blood counts and review her again in 3 months.
**Additional Investigations / Follow-up Actions:**
Repeat full blood count in 3 months. Review with haematology clinic in 3 months.
**Medications:**
No changes to current medications.
**Plan & Ongoing Care:**
Sarah will continue to be monitored in the haematology clinic. I will forward a copy of this letter to her GP, Dr. Smith, and will be in contact with Dr. Smith if any concerns arise. Please contact my rooms directly if any interim concerns arise.
Thank you again for your ongoing care of Sarah. Should any concerns or queries arise, please feel welcome to contact my rooms directly.