Murray C, Cooper B, Kitchens L W
Cancer. 1983 Sep 15;52(6):967-70. doi: 10.1002/1097-0142(19830915)52:6<967::aid-cncr2820520605>3.0.co;2-y.
Refractory dysmyelopoietic anemia (RDA) is a myeloproliferative disorder usually of elderly patients which often evolves into acute myelogenous leukemia (AML). AML in such patients is usually considered untreatable with standard aggressive chemotherapy in part because these patients are often elderly, but primarily because of the concern that the bone marrow of these patients no longer has a residual stem cell to repopulate the bone marrow following chemotherapy-induced aplasia. The authors treated three patients (ages 72, 69, and 62 years, respectively) with intensive chemotherapy after RDA evolved into AML. Each patient had been pancytopenic for 3 to 15 months prior to their transition to AML. At the onset of therapy for AML, all were severely pancytopenic with greater than 50% myeloblasts in the bone marrow. All patients had bone marrow aplasia by day 14 after chemotherapy with a complete bone marrow remission and normal peripheral counts by day 26. These data suggest that intensive chemotherapy of AML with prior RDA may result in complete bone marrow remission.
难治性骨髓生成异常性贫血（RDA）是一种通常发生于老年患者的骨髓增殖性疾病，常进展为急性髓系白血病（AML）。这类患者的AML通常被认为无法用标准的积极化疗进行治疗，部分原因是这些患者往往年事已高，但主要是因为担心这些患者的骨髓在化疗诱导的再生障碍后不再有残余干细胞来重新填充骨髓。作者对3例患者（年龄分别为72岁、69岁和62岁）在RDA进展为AML后进行了强化化疗。在转变为AML之前，每位患者全血细胞减少已达3至15个月。在AML治疗开始时，所有患者均严重全血细胞减少，骨髓中原始粒细胞大于50%。化疗后第14天所有患者均出现骨髓再生障碍，到第26天骨髓完全缓解且外周血细胞计数恢复正常。这些数据表明，对先前患有RDA的AML患者进行强化化疗可能会导致骨髓完全缓解。
