The progression of severe aplastic anemia to hypoplastic leukemia in a long-term observation after the administration of pegylated rHuMGDF.

Maho Ishikawa,Akira Matsuda,Tomoya Maeda,Daisuke Okamura,Norio Asou,Nobutaka Kawai,Masami Bessho

doi:10.4081/hr.2018.7679

Abstract

Thrombopoietin (TPO) is a critical regulator of hematopoiesis. We previously reported that a severe aplastic anemia (SAA) who received a short-term administration of pegylated recombinant human megakaryocyte growth and development factor (rHuMGDF). A trilineage hematologic response was induced, however the patient was diagnosed with leukemia after nine years and eight months from administration of rHuMGDF. In recent reports, somatic mutations in myeloid cancer candidate genes were present in one-third of the AA. A mutant clone may be expanded by rHuMGDF in our patient. The long-term safety of patients treated with TPO and eltrombopag remains unknown. Careful observations are warranted hereafter.

Highlights

Com Introduction - Aplastic anemia (AA) is one of the lifen threatening bone-marrow failure syndromes o characterized by pancytopenia and N hypoplastic marrow
We report here the meaningful clinical course of a Japanese patient with severe aplastic anemia n (SAA), hematopoietic stem cell transplantation our hospital
The patient was readmitted to our hos- leukemia in a long-term observation after age and stage of severity

Summary

Introduction

Com Introduction - Aplastic anemia (AA) is one of the lifen threatening bone-marrow failure syndromes o characterized by pancytopenia and N hypoplastic marrow. His bone marrow TPO was canceled principally because the short-term administration of rHuMGDF is (BM) showed hypocellularity with 23% production of the anti-TPO antibody in subsuspected of contributing to this clonal evo- blasts, which were peroxidase (+), CD13 jects received TPO. About 15% of lack HSCs. we thought that the hematopoiesis has received considerable AA patients have a risk of development of short-term administration of rHuMGDF attention adopt a perspective of clonal evo- MDS/AML.

Results

Conclusion