Idiopathic refractory sideroachrestic anemia (IRSA) progressing to acute mixed lymphoblastic-myelomonoblastic leukemia. Case report and review of the literature.
A longitudinal observation of a patient with idiopathic refractory sideroachrestic anemia (IRSA) progressing to acute mixed lymphoblastic-myelomonoblastic leukemia is reported. The leukemia was characterized by morphology, immunological cell markers, and dissociated clinical responsiveness to vincristine/prednisone and arabinosylcytosine/6-thioguanine. Attention is paid to the hematological changes prior to leukemia development. Acute leukemia was best heralded in this patient by a severe deterioration of dyserythropoiesis and by an increase of blasts in the marrow to more than 5%. The observed preleukemic features are compared to those described in the literature.
D000368:Aged; D000756:Anemia, Sideroblastic / Q000150:complications*; D001856:Bone Marrow Examination; D002555:Cerebrospinal Fluid / Q000166:cytology; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007938:Leukemia / Q000188:drug therapy; D007945:Leukemia, Lymphoid / Q000209:etiology*; D007948:Leukemia, Monocytic, Acute / Q000209:etiology*; D015470:Leukemia, Myeloid, Acute / Q000209:etiology*; D011014:Pneumonia / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D013866:Thioguanine / Q000627:therapeutic use; D014391:Tuberculosis, Miliary / Q000209:etiology; D014750:Vincristine / Q000627:therapeutic use
D003561:Cytarabine; D014750:Vincristine; D013866:Thioguanine; D011241:Prednisone