<s>[INST] my father is 75y/o.since 18 months ago he has been diagnosed by Myelodysblastic syndrome.he is pan cytopenic,he has hot recently whole blood transfussion  2 units,but still is anemic,thrombocytopenic and leukopenic.recently he has got bilateral leg swelling with bruises pointed in some areas on the legs.also always he suffers of itching generalised and scratching the areas and is taking oral antihistamines.do you have any specific oponion about improvement of my father general condition?thanx alot. [/INST] Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Bilateral limb swelling is due to cardiac failure. Stagnation of blood due to edema is leading to blood perfusion into subcutaneous tissue and itching.2. Limb elevation and diuretics will reduce edema. It's very important for edema to disappear to improve itching symptoms.3. Avoid plasma and go for packed cells during next transfusion in view of cardiac problems. Hope it helps. Any further queries, happy to help again. </s>