Gelatinous transformation and concomitant fibrosis of bone marrow in a patient with relapsed myelodysplastic syndrome following unrelated bone marrow transplantation.
Naonori Harada, Makoto Nishijima, Yuto Izuta et al.
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Case in brief
A 69-year-old woman with myelodysplastic syndrome (MDS) underwent unrelated bone marrow transplantation and initially achieved complete remission. However, she later developed acute skin graft-versus-host disease (GVHD) and subsequently presented with pancytopenia, severe anorexia, and significant weight loss. Bone marrow biopsy revealed gelatinous transformation and fibrosis. Her condition progressed to acute myeloid leukemia, which was refractory to treatment, ultimately leading to her death.
What made this case unusual
The simultaneous occurrence of gelatinous transformation of bone marrow and fibrosis in a patient with relapsed MDS post-transplantation is rarely described, highlighting a complex interaction between neoplastic processes and chronic GVHD.
Diagnostic / clinical pearl
Clinicians should consider the possibility of gelatinous transformation of bone marrow in patients with MDS who present with pancytopenia and significant weight loss, especially following transplantation.
Why it matters
Understanding the coexistence of gelatinous transformation and marrow fibrosis can aid in recognizing potential complications in post-transplant patients, influencing management strategies.