Peningkatan profil klinik-hematologi pada pasien sindrom mielodisplasia multilini paska splenektomi total

Abstract

Myelodysplasia syndrome (MDS) is a hematologic disorder manifested by cytopenia and rarely with splenomegaly. Clinical complaints that often accompany symptoms of anemia and when experiencing splenomegaly, the patient feels a full stomach or sometimes pain in the upper left abdomen. We report a case of a 55 year old woman with a full stomach complaint with a history of thrombocytopenia. From the peripheral blood examination, observation of thrombocytopenia was obtained with suspicion of the inflammatory process and physical examination of splenomegaly. Bone marrow aspiration studies revealed a multi-line cytopenic refractory MDS. Patients receive immunosuppressant therapy without blood transfusions. After 1 year of treatment the patient complained of fatigue and upper left abdominal pain. The results showed pancytopenia and splenomegaly. The doctor and patient discussion agreed to the splenectomy. The patient had no complications after splenectomy and for 11 months the patient felt complaint free and normal hematological parameters with a good quality of life. This case report suggests that splenectomy can be an alternative therapy for MDS that is refractory to previous therapy and is complaining of splenomegaly. Splenectomy can improve the clinical complaints and hematologic profile of MDS patients with splenomegaly.