Myelodysplastic changes in three cases within 100 days after allogeneic bone marrow transplantation.
Three patients with severe aplastic anemia, acute promyelocytic leukemia (M3) and chronic myelogenous leukemia, developed myelodysplastic changes with trilineage morphological abnormalities in a few months following allogenic bone marrow transplantation (BMT). Morphologically dysplastic changes associated with moderate-severe anemia, leukopenia and/or thrombocytopenia appeared on day 40, day 62 and day 68 after BMT. A ferrokinetics study clearly showed ineffective erythropoiesis in one patient. Hematopoietic cells were shown to be of donor-origin in all three cases. The levels of vitamin B12 and folic acid were normal. Laboratory tests showed no signs of hemolysis or fragmentation of red blood cells. Although the cause of aberrant hematopoiesis compatible with MDS within 100 days post-BMT remains to be determined, cytomegalovirus infection, ganciclovir and/or graft-versus host disease (GVHD) might be associated with this myelodysplasia following allogeneic BMT.
Okamoto
T
T
2nd Department of Internal Medicine, Hyogo College of Medicine, Japan.
Kanamaru
A
A
Okada
M
M
Kawaguchi
K
K
Saheki
K
K
Takatsuka
H
H
Fujimori
Y
Y
Takemoto
Y
Y
Kohsaki
M
M
Kakishita
E
E
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000209:etiology / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D006410:Hematopoiesis; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000209:etiology / Q000473:pathology; D015473:Leukemia, Promyelocytic, Acute / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000473:pathology; D014184:Transplantation, Homologous