Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: gi bleed/anemia major surgical or invasive procedure: high risk egd : impression: mild schatzki's ring hemorrhagic gastritis in the antrum mass in the distal body along the lesser curvature, no ulcers and no significant active bleeding from mass noted otherwise normal egd to third part of the duodenum recommendations: continue with high dose ppi therapy consider octreotide drip as adjunct to ppi therapy continue with platetelet and prbc transfusions bilroth ii gastrectomy/reconstruction history of present illness: mr. is an 85 year old male with a history of myelodysplastic syndrome and relapsed gastric malt lymphoma status post three episodes of upper gi bleeding (, and ) and treated with rituximab, xrt, and attempted egd interventions which have failed. he was transferred to the with anemia that is refractory to prbc transfusions. he has transfusion-dependent mds, which did not respond to 3 months of dacogen, and receives platelet transfusions m/w/f and blood 2-3 units/week. presents to clinic today with fatigue, back pain, and acute drop if hct from 30 to 22 over the course of 2 days. . the patient was last seen at clinic 2 days prior to this admission. at that time, he was transfused platelets and had a hct of 30. today, he presented to clinic in a wheelchair with notable fatigue. he has also had worsening back pain that started 3 days prior to admission. he had a repeat cbc, which showed a hct 22 and plt 8, so the patient was admitted to the hospital. he was initially admitted to the service where he was hemodynamically stable (sbp low 100s). he did have a tarry bowel movement today. he was transfused 2 packs of platelets and 2 units prbcs on the floor. hct drawn after the first unit of prbcs showed a drop from 22.4 to 20.1. the patient was transferred to the icu after the 2nd unit of prbcs for closer monitoring and concern for brisk gib. . the patient reports some back pain that started 3 days prior to admission, but has no other complaints. no sob, cp, lightheadedness, nausea, vomiting. he had an episode of melena today, but no brbpr. past medical history: oncologic history: 1. mds on dacogen - presented in with pancytopenia, complained of dyspnea on exertion - cytopenias progressed and he had a repeat bone marrow done in which showed a markedly hypercellular bone marrow with significant dysplasia in the erythroid and megakaryocytic lineages. there were >15% ringed sideroblasts. flow cytometry demonstrated cd-34-positive cells comprised 4-5% of total blast gated events. cytogenetics revealed cells have abnormal chromosome 12 and an abnormal chromosome 17 in a possible three way translocation. - refractory to procrit, at escalating doses and then became red blood cell transfusion dependent - decitabine therapy was initiated but had to be discontinued due to a hematoma which developed at the site of a wound. he resumed c1d1 dacogen for mds on . so far he has tolerated therapy well but remains severely pancytopenic and requires frequent blood product support. . 2. malt lymphoma of the stomach: no evidence of disease since - initially presented in with abdominal upset/indigestion. ct scan demonstrated perigastric adenopathy and egd had a multilobulated mass with ulceration. biopsy demonstrated extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (malt). - bone marrow biopsy demonstrated mildly hypercellular marrow for age with megakaryocytic dysplasia and occasional ringed sideroblasts (10%) without evidence of lymphoma. evolving myelodysplastic syndrome could not be excluded. - treated for stage iib malt lymphoma of the stomach with 6 cycles of cvp, completed in - recurred in and was treated with four weeks of rituxan therapy () - no evidence of disease since this time. . other past medical history: open aaa repair- cataract surgery htn social history: the patient is married with two children, three grandchildren and four great grandchildren. he smoked a pack a day for 40 years and quit in . he previously drank heavily, currently only 2 drinks/day. he is a retired electrician. family history: mother-died in her 70s of acute leukemia father-died of aaa sister-hemochromatosis physical exam: on admission gen: nad vs: t37.4, bp 115/50, hr 77, rr 20 heent: mmm, no op lesions, neck is supple, no cervical, supraclavicular, or axillary lad cv: rr, nl s1s2 no s3s4 mrg pulm: ctab abd: bs+, soft, ntnd, no masses or hsm, no stigmata of chronic liver disease limbs: no le edema, no tremors or asterixis, no clubbing skin: no rashes or skin breakdown neuro: cnii-xii nonfocal, motor/sensory grossly intact pertinent results: 07:31pm wbc-0.5* rbc-2.37* hgb-7.1* hct-20.1* mcv-85 mch-29.9 mchc-35.1* rdw-14.0 07:31pm plt count-28*# 07:31pm pt-14.3* ptt-33.8 inr(pt)-1.2* 07:31pm fibrinoge-312 03:47pm plt count-18*# 12:30pm urea n-41* creat-1.2 sodium-140 potassium-5.2* chloride-107 total co2-24 anion gap-14 12:30pm alt(sgpt)-32 ast(sgot)-22 ld(ldh)-99 alk phos-105 tot bili-0.5 dir bili-0.2 indir bil-0.3 12:30pm calcium-9.1 phosphate-3.2 magnesium-2.5 12:30pm haptoglob-138 12:30pm wbc-0.5* rbc-2.58*# hgb-7.9* hct-22.1*# mcv-86 mch-30.8 mchc-35.9* rdw-13.9 12:30pm neuts-60 bands-0 lymphs-24 monos-16* eos-0 basos-0 atyps-0 metas-0 myelos-0 12:30pm hypochrom-1+ anisocyt-normal poikilocy-occasional macrocyt-normal microcyt-normal polychrom-normal ovalocyt-occasional schistocy-occasional 12:30pm plt smr-rare plt count-9*# 12:30pm gran ct-250* see procedures section for egd results. ct abd w/o contrast : 1. no evidence of retroperitoneal hemorrhage as questioned. 2. stable gastric mass, compatible with the known biopsy-proven lymphoma. 3. stable mesenteric or retroperitoneal lymphadenopathy within the abdomen. 4. stable 7 mm right lower lobe pulmonary nodule. 10:21pm blood hct-35.0* 05:45pm blood wbc-5.0 rbc-3.46* hgb-10.6* hct-30.3* mcv-88 mch-30.7 mchc-35.0 rdw-15.5 plt ct-64* 10:22pm blood pt-16.4* ptt-55.7* inr(pt)-1.5* 10:22pm blood glucose-90 urean-43* creat-2.9* na-141 k-4.3 cl-106 hco3-14* angap-25* 06:00am blood alt-28 ast-21 ld(ldh)-429* alkphos-100 totbili-0.9 10:22pm blood ck-mb-42* mb indx-12.8* ctropnt-0.58* 10:22pm blood calcium-7.6* phos-7.9*# mg-2.6 01:42am blood type-art po2-124* pco2-42 ph-7.14* caltco2-15* base xs--14 01:42am blood lactate-7.8* brief hospital course: the patient is an 85 year old male with transfusion dependent (weekly rbc and plt) mds and malt lymphoma s/p xrt and currently undergoing rituximab therapy. his malt has been complicated by reccurent upper gi bleeds and he presented to with shortness of breath, fatigue and a gi bleed. he was transferred to the after his hct did not respond to 2 units of prbcs on . # upper gi bleed: found to be secondary to hemorrhagic gastritis in the antrum of the stomach by egd on . a gi consult was obtained. the patient was kept npo and was treated with pantoprazole 40mg iv bid. his hematocrit was monitored every 6 hours. his hct remained in the 21-25 range throughout his icu admission and he was transfused one unit of prbcs before transfer. his platelets were transfused four units over the course of his admission to keep plt>50. the decision was made to consult surgery for definitive management of the gib. he was transfered to surgery postoperatively on . he had a bii gastrectomy/reconstruction. his post operative course was complicated by post operative hypotension, hemodynamic instability, coagulopathy/bleeding. he was transferred to the icu intubated. he recieved multiple blood transfusions and was placed on two pressors. despite aggressive products, he became anuric. a family meeting was held and they decided ultimately to make him cmo. care was withdrawn and the patient passed away within minutes. . communication: patient & wife , phone: and daughter , phone: ) . disposition: funeral home medications on admission: medications (per pts home med list): lantus 17 u q am, 6 units q pm humalog 2-10 units lopressor 25 mg aspirin 325 q am tegretol 300 mg tid crestor 40 mq qhs zetia 10 mg q pm protonix 40 mg q pm imdur 90 mg q am fluvaxamine 37.5 advair 250/50 flonase 2 sprays q am claritin 1 q am tylenol 500 prn discharge medications: n/a discharge disposition: expired discharge diagnosis: post operative hemodynamic instability discharge condition: na discharge instructions: na followup instructions: na procedure: venous catheterization, not elsewhere classified other enterostomy other endoscopy of small intestine cholecystectomy excision or destruction of peritoneal tissue total splenectomy partial gastrectomy with anastomosis to jejunum diagnoses: acidosis acute posthemorrhagic anemia acute kidney failure, unspecified unspecified septicemia severe sepsis myelodysplastic syndrome, unspecified calculus of gallbladder with other cholecystitis, without mention of obstruction late effect of radiation radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified gastritis, with hemorrhage marginal zone lymphoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to