Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 561

A full discussion of clonal disorders is beyond the scope of this chapter. In general, the term clonal disorders refers to genetic aberrations in hematopoietic progenitor cells, which are typically in the bone marrow. These conditions include clonal haematopoiesis of indeterminate potential (CHIP), myelodysplastic syndrome (MDS), monoclonal gammopathy of undetermined significance (MGUS), aplastic anaemia, and acute myeloid dysplasia (MDS). A defining feature in anaemia of clonal disorders is stem cell mutations that lead to abnormal blood cell proliferation and progressive bone marrow failure. Diagnostic clues include the presence of macrocytic anaemia, anaemia with concurrent leukopenia, thrombocytopenia, and low to normal reticulocyte count. If suspected, a prompt referral to a haematology specialist should be made. Diagnostic confirmation is made by a bone marrow biopsy and requires cytogenetic and molecular studies.