A 41 year old man presents to you with pancyto-penia. He is asymptomatic except for mild fatigue. Liver, pulmonary, and kidney function are normal. Bone marrow biopsy is normocellular with multiline-age dysplasia. Myeloblasts represent 15% of the marrow cellularity. There are no circulating peripheral blasts. Chromosome analysis reveals monosomy 7 in 13 of 20 metaphases. The patient's brother is healthy and HLA-identical. Based on the patient's diagnosis of myelodysplastic syndrome, high international prognostic scoring system, lack of comorbidities, and available HLA-identical sibling donor, you recommend allogeneic hematopoietic cell transplantation (HCT) [1].
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