Iatrogenic myelodysplastic syndrome complicating multiple sclerosis: A case report

After 1.5 years of treatment with dimethyl fumarate (DMF) for multiple sclerosis, preceded 8 years earlier by intravenous (IV) cladribine and 1 year earlier by natalizumab, our patient developed myelodysplastic syndrome (MDS). The initial manifestation was a severe drop in absolute neutrophil and ly...

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Bibliographic Details
Published inMultiple sclerosis p. 13524585241235539
Main Authors Kubicki, Konrad, Stefoski, Dusan
Format Journal Article
LanguageEnglish
Published England 08.03.2024
Subjects
neutropenia
Multiple sclerosis
disease-modifying therapies
myelodysplastic syndrome
treatment adverse effects
lymphopenia
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Summary:After 1.5 years of treatment with dimethyl fumarate (DMF) for multiple sclerosis, preceded 8 years earlier by intravenous (IV) cladribine and 1 year earlier by natalizumab, our patient developed myelodysplastic syndrome (MDS). The initial manifestation was a severe drop in absolute neutrophil and lymphocyte counts. Repeat bone marrow biopsy demonstrated a new unbalanced translocation (between the chromosome 1 long arm and chromosome 7 short arm). This case report, to our knowledge, is the first linking iatrogenic MDS to DMF and cladribine, while also suggesting caution with immunosuppressants in multiple sclerosis patients.
ISSN:1477-0970
DOI:10.1177/13524585241235539