MYELODYSPLASTIC SYNDROME WITH PROLONGED RETICULOCYTE SURVIVAL MIMICKING HEMOLYTIC-DISEASE

A patient with myelodysplastic syndrome (refractory anemia) with marke d and persistent reticulocytosis is presented. A referring diagnosis o f hemolytic disease had been made. However, the Cr-51 red cell surviva l was normal (T-1/2 24 days). Reticulocyte morphology, red cell creati ne content, and in vitro reticulocyte survival studies have suggested that the reticulocytosis arose as a consequence of delayed maturation of the reticulocytes. Two patients with myelodysplastic syndrome and d elayed reticulocyte maturation have previously been described; in both patients, however, red cell survival was also shortened. Anemia with reticulocytosis, mimicking hemolytic disease, may be an unusual presen tation of myelodysplastic syndrome.