A 72 year old male came with a chief complaint of fever , abdominal pain , blackish stools. Patient had history of Hodgkins lymphoma completely treated. Now blood picture shows pancytopenia with hemoglobin 7.2 , wbc 1,000 ( Neutrophils 30%, Lymphocytes 60%) , platelets 24,000. Suspicion is MDS, or Hodgkins recurrence. Patient planned for whole blood transfusion, platelets, filgastrim, eltombopag, inj ceftazidime avibactam, aztreonam , metronidazole and vancomycin.