title: Remission induction of refractory anaemia with excess blasts in transformation by sole treatment with granulocyte colony-stimulating factor with persistent chromosomal abnormality.
abstract: We report a patient with myelodysplastic syndrome (MDS), refractory anaemia with excess blasts in transformation, in whom complete remission (CR) was achieved with the administration of granulocyte colony-stimulating factor (G-CSF). The 76-year-old patient was admitted to our hospital with a fever and a productive cough; a diagnosis of pneumonia was thus made. Following treatment with antibiotics, the patient's condition improved, and MDS was diagnosed from peripheral blood and bone marrow examinations after the patient recovered from the infection. The patient achieved a sustained haematological CR that was confirmed by morphological and flow cytometric examination after treatment with G-CSF alone, although chromosomal abnormalities persisted. According to the literature, in almost all patients with acute myeloid leukaemia or MDS who were reported to achieve CR by G-CSF, the course was associated with infection, although our case did not have this complication during the course of G-CSF therapy. We suggest that patients with G-CSF alone without infection can achieve CR and that this may be related to a differentiation effect of G-CSF based on persistent chromosomal abnormality in this case.
authors.affiliation: Division of Haematology and Oncology, Department of Medicine, Shimizu Kohsei Hospital, Shizuoka, Japan. hakondo@minuet.plala.or.jp
authors.forename: Haruki
authors.initials: H
authors.lastname: Kondo
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Akinori
authors.initials: A
authors.lastname: Mori
mesh_terms: D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D002890:Chromosomes, Human, Pair 20; D017353:Gene Deletion; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D017493:Leukocyte Common Antigens / Q000032:analysis; D008297:Male; D012074:Remission Induction
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D017493:Leukocyte Common Antigens