title: Therapy-related myelodysplastic syndrome following cyclophosphamide pulse and/or methotrexate therapy in a patient with systemic lupus erythematosus.
abstract: A 27-year-old woman exhibited progressive pancytopenia during cyclophosphamide pulse therapy for lupus nephritis and low-dose methotrexate therapy for severe arthralgia. Bone marrow aspiration revealed highly abnormal cell morphology, indicating therapy-related myelodysplastic syndrome. Pancytopenia and bone marrow cell morphology improved 3 months after discontinuation of cyclophosphamide. It is necessary to promptly examine bone marrow cell morphology and chromosomal aberration in cases with connective tissue diseases complicated by sudden cytopenia during immunosuppressive therapy with chemotherapeutic agents.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan. haru-i@fmu.ac.jp
authors.forename: Haruyo
authors.initials: H
authors.lastname: Iwadate
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Kiori
authors.initials: K
authors.lastname: Yano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ikeda
authors.forename: Kazuei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000328:Adult; D001854:Bone Marrow Cells / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy*; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D010198:Pancytopenia / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008727:Methotrexate