Secondary leukemia after severe aplastic anemia.
We describe a patient with acute myeloid leukemia (AML) occurring 5 years after successful treatment of severe aplastic anemia (SAA) with antilymphocyte globulin (ALG). Four years after ALG, SAA had relapsed. A second remission of SAA was achieved, but was followed by transformation of the myelodysplastic syndrome into overt AML. After 2 courses of high-dose cytosine arabinoside and VP-16 complete remission occurred. This case shows that chemotherapy of secondary leukemia after SAA is feasible, and that ex-aplastic bone marrow is capable of complete recovery from chemotherapy-induced aplasia. Morphological anomalies of bone marrow noticed early during remission of SAA might predict a late transformation in leukemia.
Department of Internal Medicine, Kantonsspital, Basel, Switzerland.
A
A
Tichelli
A
A
Gratwohl
A
A
Würsch
C
C
Nissen
B
B
Speck
D000293:Adolescent; D000741:Anemia, Aplastic / Q000150:complications* / Q000628:therapy; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002478:Cells, Cultured; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology*; D008297:Male
D000961:Antilymphocyte Serum