A Rare Concurrence of Myelodysplastic Neoplasia and Tetrasomy 8 in a 3-Year-Old Bahraini Male

Myelodysplastic neoplasia (MDS) is a group of stem cell disorders involving ineffective hematopoiesis. It can be associated with an increased risk progression toward acute myeloid leukemia (AML). In Bahrain, MDS the fifth most common primary hematologic malignancy. has annual incidence up to 4 million cases. Some presenting signs and symptoms are often nonspecific, such as fatigue, pallor, malaise, fevers, bleeding, bruising, weight loss, anorexia. Approximately 40% patients progress AML. This paper outlines case 3-year-old Bahraini male (known have sickle trait) who presented emergency department Salmaniya Medical Complex five-day history fever, congested throat, left ear pain, abdominal pain. He had one episode vomiting gastric content previous day. previously gone private clinic similar symptoms. Physical examination revealed short neck stature, which was found below 5th percentile. generalized pallor hepatosplenomegaly. A blood smear showed leukopenia normochromic normocytic anemia. There were excessive blasts consisted 17% nucleated cells few granulopoietic cells. Erythropoiesis active showing mild megaloblastic changes. rare megakaryocytes noted. Moreover, bone marrow aspirate two populations on dim CD45. The first population 3.15% CD45 comprising hematogones brightly expressed CD19, HLA-DR, CD79a, CD10. second 14.85% CD34, CD13, CD117, CD7. Based peripheral immunophenotyping findings, diagnosis myelodysplastic syndrome made, soon transformed into Furthermore, levels dysplastic changes percentage in lead higher possibility transformation As per WHO classification, needs evaluation morphology marrow.