Evolution of severe aplastic anemia to myelodysplasia with monosomy 7 following granulocyte colony-stimulating factor, erythropoietin and high-dose methylprednisolone combination therapy.
A 19-year-old man was diagnosed as having severe aplastic anemia and received high-dose methylprednisolone treatment without hematological response. A second course of high-dose mPSL treatment together with granulocyte colony-stimulating factor (G-CSF) plus erythropoietin (EPO) was then started and resulted in trilineage blood cell response. Ten months after the combination therapy thrombocytopenia developed and cytogenetic analysis showed 45,XX,-7, indicating an evolution to myelodysplastic syndrome (MDS) associated with monosomy 7.G-CSF and EPO treatment together with immunosuppression may be an effective therapy in SAA patients, but such a therapy may increase the risk of evolution to MDS.
Ohsaka
A
A
Department of Internal Medicine, Hitachi General Hospital, Ibaraki.
Sugahara
Y
Y
Imai
Y
Y
Kikuchi
M
M
D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000188:drug therapy*; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics*; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000009:adverse effects*; D005938:Glucocorticoids / Q000009:adverse effects*; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects*; D009006:Monosomy / Q000235:genetics*; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000235:genetics
D005938:Glucocorticoids; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D008775:Methylprednisolone