Marry smith 48 current outpatient active issue pancytopenia with ongoing haemolytic

anaemia this occurs in the context of unrelated allogeneic stem cell transplant
undertaken for post polycythaemia Vera myelofibrosis in addition to cytopenia
other complications of transplant has impact on Marry recent health include GVHD
with gastrointestinal tract with consequent malnutrition, infection in the setting of
pancytopenia and recent pneumothorax
In terms of M inactive problem digital amputation as a complication of PV, previous
melanoma as well as remote history of Hodgkins lymphoma
Despite this M keeps positive outlook and retains impressive functional capacity she
attributes this to support from her family

48 yrs lady 9 months post allogeneic stem cell transplant for post PV myelofibrosis
and Marry has appropriately identified ongoing haemolysis as her primary concern
indeed haemolysis in the setting of pancytopenia will present the greatest risk for
her wellbeing and life.

In summary 33 Mara with transfusion acquired HIV and HCV coinfection following in
treatment for sever Haemophilia a His prognosis is largely governed by management
of compensated cirrhosis