<症例>ブスルファンによる骨髄抑制後急性骨髄性白血病に移行した真性赤血球増加症の1例

概要

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An autopsy case of acute leukemia transformed from polycythemia vera (PV) was reported. A 75-year-old female had been treated with busulfan for PV from March 1981 to January 1982. She was admitted to the Kinki University Hospital because of sore throat and hemoptysis. Seven months before admission, a diagnosis of hypoplastic anemia due to busulfan was made from the findings of pancytopenia in the peripheral blood and bone marrow suppression, and the administration of the drug was stopped. On admission, red cell, leukocyte and platelet counts were 1,550,000,0.6×10^3 and 9,000/μl respectively. The cell count of bone marrow was 65,000/μl with 85.6% atyrical blast cells. A diagnosis of acute myelogenous leukemia was made. She died from Aspergillus infection 33 days after admission. Busulfan causes prolonged hypoplasia of bone marrow and it may induce a permanent genetic change in the stem cells to repair itself. These findings suggest that busulfan is leukemogenic, though its mode of action is uncertain.
近畿大学の論文
1986-12-25