Hyperhemolysis syndrome (HS) should be considered in a multiply transfused thalassemia patient. HS in this patient was attributed to a combination of factors including multiple transfusions, presence of anti-Cw, macrophage hyperactivity, hypersplenism and suppression of erythropoiesis.

A 59-year old gentleman with transformation of myelodysplastic syndrome to acute megakaryoblastic leukemia was treated with standard intensive chemotherapy. His poor outcome was attributed to advanced age, aggressive disease biology, underlying myelodysplastic syndrome, poor response to induction chemotherapy, high lactate dehydrogenase and lack of good cytogenetic and molecular mutations.

An 80-year old gentleman with very severe aplastic anemia was treated with standard combination therapy of equine antithymocyte globulin and cyclosporine A. His death shortly after treatment could be attributed to his advanced age, severe pancytopenia at diagnosis, absence of minor paroxysmal nocturnal hemoglobinuria clone and immunosuppressive therapy-related complications.