A 78 -year-old woman who resides in a nursing home is being examined for an infection on her foot and increasing fatigue. Laboratory studies show a HB 9.8 g/dL, MCV 110, RBC 3.5 million cells/mcL, and WBC count of 3000 cells/mcL. A bone marrow biopsy specimen shows hypercellularity and dysplasia with 10% myeloblasts. This patient’s current disorder may progress into which of the following?