A rare atypical myeloproliferative-disorder-like hemopathy with marked dysplasia, peripheral dominant myeloblast proliferation and extramedullary hematopoiesis was converted into typical acute myeloid leukemia with an interval of complete hematological remission.
We describe a patient with leukocytosis with all the stages of neutrophilic series, peripheral dominant myeloblast proliferation, marked dysplasia of myeloid and erythroid series, and extramedullary hematopoiesis of the lymph nodes. A cytogenetic study of the bone marrow cells showed normal karyotype, and molecular analysis of the leukemic cells showed negative for BCR-ABL by RT-PCR. After chemotherapy, the patient went into complete remission with a normal blood and bone marrow profile with no dysplasia. On relapse, the hematological findings showed a typical bone marrow dominant acute myeloid leukemia, with the leukemic cells having a chromosomal abnormality. The patient exhibited the combined features of myeloproliferative disorder, myelodysplastic syndrome, peripheral dominant myeloblast proliferation (so-called peripheral leukemia) and typical acute myeloid leukemia throughout the clinical course. This is thought to be a rare overlapping disease involving these distinct hematological conditions that do not usually occur in the same patient.
Department of Medicine, Hospital, International Medical Center of Japan, Tokyo, Japan.
S
S
Hagiwara
A
A
Yuo
A
A
Miwa
N
N
Takezako
N
N
Hirano
A
A
Togawa
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003630:Daunorubicin / Q000008:administration & dosage; D018450:Disease Progression; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D007951:Leukemia, Myeloid / Q000473:pathology*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000473:pathology*; D009196:Myeloproliferative Disorders / Q000188:drug therapy / Q000473:pathology*; D011239:Prednisolone / Q000008:administration & dosage; D011289:Preleukemia / Q000473:pathology*; D012074:Remission Induction
D003561:Cytarabine; D011239:Prednisolone; D015122:Mercaptopurine; D003630:Daunorubicin