<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A previously healthy 75-year-old woman comes to the physician because of fatigue and decreasing exercise tolerance over the past 6 weeks. She also has intermittent episodes of dizziness. She has never smoked and does not drink alcohol. She takes a daily multivitamin. She appears pale. Physical examination shows a smooth liver that is palpable 1 cm below the costal margin. The spleen is not palpable. Laboratory studies show:Hemoglobin 9.8 gdLMCV 104 fLReticulocyte count 0.2 Folate 21 ngmL N 220Vitamin B12 789 pgmL N 200900A peripheral blood smear shows anisocytosis and bone marrow aspirate shows ringed sideroblasts. This patient is most likely to develop which of the following?? A: Sézary syndrome, B: Chronic lymphocytic leukemia, C: Burkitt lymphoma, D: Acute myelocytic leukemia, E: Hairy cell leukemia,  <response>: Based on the information provided in the question stem, this patient is a 75-year-old woman with symptoms of fatigue, decreased exercise tolerance, and dizziness over the past 6 weeks. Key findings on exam include pallor, palpable smooth liver, elevated MCV, low reticulocyte count, and ringed sideroblasts on bone marrow aspirate. The enlarged smooth liver, anemia, and ringed sideroblasts point towards a diagnosis of myelodysplastic syndrome, likely refractory anemia with ring sideroblasts RARS. The normal folate and vitamin B12 levels make nutritional deficiency less likely. The peripheral smear and bone marrow findings are not consistent with the lymphoma or leukemia choices.D: Acute myelocytic leukemia 