Tichelli A, Gratwohl A, Würsch A, Nissen C, Speck B
Department of Internal Medicine, Kantonsspital, Basel, Switzerland.
Blut. 1988 Feb;56(2):79-81. doi: 10.1007/BF00633468.
We describe a patient with acute myeloid leukemia (AML) occurring 5 years after successful treatment of severe aplastic anemia (SAA) with antilymphocyte globulin (ALG). Four years after ALG, SAA had relapsed. A second remission of SAA was achieved, but was followed by transformation of the myelodysplastic syndrome into overt AML. After 2 courses of high-dose cytosine arabinoside and VP-16 complete remission occurred. This case shows that chemotherapy of secondary leukemia after SAA is feasible, and that ex-aplastic bone marrow is capable of complete recovery from chemotherapy-induced aplasia. Morphological anomalies of bone marrow noticed early during remission of SAA might predict a late transformation in leukemia.
我们描述了一名患者，其在使用抗淋巴细胞球蛋白（ALG）成功治疗严重再生障碍性贫血（SAA）5年后发生了急性髓系白血病（AML）。使用ALG四年后，SAA复发。再次实现了SAA的缓解，但随后骨髓增生异常综合征转变为明显的AML。在接受2个疗程的大剂量阿糖胞苷和VP - 16治疗后，实现了完全缓解。该病例表明，SAA后继发性白血病的化疗是可行的，且再生障碍性骨髓能够从化疗引起的再生障碍中完全恢复。在SAA缓解早期发现的骨髓形态学异常可能预示着白血病的晚期转变。
