[RAEB in T with monosomy 7 after treatment of severe aplastic anemia with long term G-CSF].
A 19-year-old male who suffered from severe aplastic anemia had been treated with granulocyte colony stimulating factor (G-CSF) from September 1991. Marked increase of hematopoietic cells in his bone marrow was observed, and maintenance administration of G-CSF was continued. 15 months later, myeloblasts with nuclear abnormality increased, and 22 months later, myeloblasts with chromosomal abnormality presenting 46, XY, -7, +21 exceeded 20%, and aplastic anemia seemed to be transformed into refractory anemia with excess of blasts in transformation (RAEB in T). The usefulness of G-CSF in the treatment of aplastic anemia is now established, but there are some reports questioning the effect of long-term administration, especially transformation to MDS with monosomy 7. Leukemic transformation from aplastic anemia is very complex, but in some cases, long term administration of G-CSF may affect the natural course and may lead to the earlier development of leukemia.
Kaito
K
K
Second Department of Internal Medicine, Jikei University School of Medicine.
Otsubo
H
H
Ogasawara
Y
Y
Sekita
T
T
Saeki
A
A
Nishiwaki
K
K
Masuoka
H
H
Shimada
T
T
Kobayashi
M
M
Sakai
O
O
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D000754:Anemia, Refractory, with Excess of Blasts / Q000209:etiology* / Q000235:genetics*; D002869:Chromosome Aberrations; D002897:Chromosomes, Human, Pair 7; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009006:Monosomy
D016179:Granulocyte Colony-Stimulating Factor