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Updated: Aug 10, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Myelodysplasia with isolated trisomy 15: a 15-year follow-up without specific therapy
1Department of Medical Education, Christus St. Joseph Hospital, 1401 Saint Joseph Parkway, Houston, Texas 77002, USA. natelson@pipeline.com
Abstract:
A 41-year-old patient manifested pancytopenia with macrocytosis following pesticide exposure. She was later found to have myelodysplasia with trisomy 15. Over a 15-year period of observation, and with no specific therapy, her hematological disorder remains stable, despite persistence of the chromosomal aberration. This and similar reported observations suggest that the course of this uncommon form of myelodysplasia is often indolent and not accurately predicted by application of the widely used International Prognostic Scoring System for the myelodysplastic syndromes.
Insights
Pesticide exposure can lead to myelodysplasia with trisomy 15. This rare blood disorder often follows an indolent course, challenging standard prognostic scoring systems.
Area of Science:
- Hematology
- Genetics
- Toxicology
Background:
- Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
- Trisomy 15 is a rare chromosomal abnormality observed in some MDS cases.
- Pesticide exposure is an environmental factor being investigated for its role in hematological malignancies.
Observation:
- A 41-year-old patient presented with pancytopenia and macrocytosis after pesticide exposure.
- The patient was diagnosed with myelodysplasia associated with trisomy 15.
- A 15-year observation period revealed a stable hematological status without specific therapy.
Findings:
- The patient's myelodysplasia remained stable despite the persistent trisomy 15.
- This case suggests an indolent clinical course for this specific type of myelodysplasia.
- The International Prognostic Scoring System (IPSS) may not accurately predict outcomes in such cases.
Implications:
- This observation highlights the need for individualized prognostication in myelodysplastic syndromes.
- Environmental factors like pesticide exposure warrant further investigation in MDS etiology.
- Understanding rare chromosomal aberrations in MDS can refine diagnostic and prognostic approaches.