Anderson A L, Lynch E C
Arch Intern Med. 1980 Jul;140(7):976-7.
We describe a patient with a myelodysplastic syndrome characterized by pancytopenia and an excess of myeloblasts in the bone marrow. He had received massive doses of diethylstilbestrol (150 mg daily) for seven years as therapy for prostatic carcinoma. Although myelodyspoiesis has been associated with other drugs, a relationship to estrogen therapy in man has not been reported previously. However, the administration of estrogens to animals has produced pancytopenia with a relative monocytosis and vacuolization of leukocytes. Examination of bone marroa, erythroid hypoplasia, and, with prolonged therapy, aplastic anemia. Further animal studies have demonstrated that estrogens exert a suppressive effect on marrow stem cells and granuloid progenitor cells. These experimental observations suggest a possible role of estrogens in the genesis of the hematologic changes we observed.
我们描述了一名患有骨髓增生异常综合征的患者，其特征为全血细胞减少以及骨髓中原始粒细胞过多。他曾接受大剂量己烯雌酚（每日150毫克）治疗前列腺癌达七年之久。虽然骨髓生成异常已与其他药物有关，但此前尚未报道其与人雌激素治疗之间的关系。然而，给动物使用雌激素已导致全血细胞减少，并伴有相对单核细胞增多以及白细胞空泡化。骨髓检查显示红细胞生成减少，且长期治疗后会出现再生障碍性贫血。进一步的动物研究表明，雌激素对骨髓干细胞和粒细胞祖细胞具有抑制作用。这些实验观察结果提示雌激素在我们所观察到的血液学变化的发生过程中可能发挥了作用。
