Ohsaka A, Sugahara Y, Imai Y, Kikuchi M
Department of Internal Medicine, Hitachi General Hospital, Ibaraki.
Intern Med. 1995 Sep;34(9):892-5. doi: 10.2169/internalmedicine.34.892.
A 19-year-old man was diagnosed as having severe aplastic anemia and received high-dose methylprednisolone treatment without hematological response. A second course of high-dose mPSL treatment together with granulocyte colony-stimulating factor (G-CSF) plus erythropoietin (EPO) was then started and resulted in trilineage blood cell response. Ten months after the combination therapy thrombocytopenia developed and cytogenetic analysis showed 45,XX,-7, indicating an evolution to myelodysplastic syndrome (MDS) associated with monosomy 7.G-CSF and EPO treatment together with immunosuppression may be an effective therapy in SAA patients, but such a therapy may increase the risk of evolution to MDS.
一名19岁男性被诊断为重型再生障碍性贫血，接受大剂量甲泼尼龙治疗后血液学无反应。随后开始第二疗程的大剂量甲泼尼龙联合粒细胞集落刺激因子（G-CSF）加促红细胞生成素（EPO）治疗，结果出现三系血细胞反应。联合治疗10个月后出现血小板减少，细胞遗传学分析显示45,XX,-7，提示向伴有7号染色体单体的骨髓增生异常综合征（MDS）演变。G-CSF和EPO治疗联合免疫抑制可能是重型再生障碍性贫血患者的有效治疗方法，但这种治疗可能会增加向MDS演变的风险。
