Kaito K, Otsubo H, Ogasawara Y, Sekita T, Saeki A, Nishiwaki K, Masuoka H, Shimada T, Kobayashi M, Sakai O
Second Department of Internal Medicine, Jikei University School of Medicine.
Rinsho Ketsueki. 1995 Apr;36(4):365-70.
A 19-year-old male who suffered from severe aplastic anemia had been treated with granulocyte colony stimulating factor (G-CSF) from September 1991. Marked increase of hematopoietic cells in his bone marrow was observed, and maintenance administration of G-CSF was continued. 15 months later, myeloblasts with nuclear abnormality increased, and 22 months later, myeloblasts with chromosomal abnormality presenting 46, XY, -7, +21 exceeded 20%, and aplastic anemia seemed to be transformed into refractory anemia with excess of blasts in transformation (RAEB in T). The usefulness of G-CSF in the treatment of aplastic anemia is now established, but there are some reports questioning the effect of long-term administration, especially transformation to MDS with monosomy 7. Leukemic transformation from aplastic anemia is very complex, but in some cases, long term administration of G-CSF may affect the natural course and may lead to the earlier development of leukemia.
一名19岁的重度再生障碍性贫血男性患者自1991年9月起接受粒细胞集落刺激因子（G-CSF）治疗。观察到其骨髓造血细胞显著增加，并持续进行G-CSF维持治疗。15个月后，出现核异常的成髓细胞增多，22个月后，呈现46, XY, -7, +21染色体异常的成髓细胞超过20%，再生障碍性贫血似乎转变为转化型难治性贫血伴原始细胞增多（RAEB - T）。G-CSF在再生障碍性贫血治疗中的有效性现已确立，但有一些报道对长期使用的效果提出质疑，尤其是转化为伴有7号染色体单体的骨髓增生异常综合征。再生障碍性贫血向白血病的转化非常复杂，但在某些情况下，长期使用G-CSF可能会影响其自然病程，并可能导致白血病的早期发生。
