Co-existent MDS and lymphoma in a young pregnant woman: A case report and literature review

Abstract

Myelodysplastic neoplasms (MDS) represent a diverse group of clonal myeloid disorders marked by ineffective hematopoiesis, leading to cytopenias and dysplastic hematopoietic cells. Rarely, MDS may coexist with Non-Hodgkin Lymphoma (NHL), often emerging as a secondary complication post-lymphoma treatment. However, concurrent diagnosis of MDS and lymphoma prior to any chemotherapy or radiotherapy exposure is uncommon. This article discusses a rare case of co-existent MDS and T-cell lymphoma in a young pregnant woman, along with a literature review. Clinical findings, laboratory results, and bone marrow aspiration indicated the presence of both MDS and NHL, with subsequent lymph node biopsy confirming T-cell lymphoma. Literature reveals multiple hypotheses for the coexistence of MDS and lymphomas, including common pathogenic pathways, overlapping genetic mutations, or shared immunological abnormalities. Mutations like TP53, ASXL1, DNMT3A, and RUNX1 are frequently implicated in both MDS and lymphoma and suggest a potential common origin for these diseases. Prognosis remains poor for patients with concurrent MDS and NHL due to limited therapeutic options. Treatment is complex and must consider patient age, comorbidities, and MDS and lymphoma subtypes. Advances in genetic analysis provide insights into the shared etiology of these diseases, potentially aiding in future therapeutic approaches. This case underscores the clinical and therapeutic challenges presented by concurrent MDS and lymphoma and highlights the need for specific management strategies.