Effective azacitidine treatment for myelodysplastic syndrome transformed from essential thrombocythemia

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  • IIZUKA Hiromitsu
    Department of Hematology and Oncology, The University of Tokyo Hospital
  • YOSHIMI Akihide
    Department of Hematology and Oncology, The University of Tokyo Hospital
  • YAMAMOTO Go
    Department of Hematology and Oncology, The University of Tokyo Hospital
  • MASUDA Akiko
    Department of Clinical Laboratory, The University of Tokyo Hospital
  • NANNYA Yasuhito
    Department of Hematology and Oncology, The University of Tokyo Hospital
  • ICHIKAWA Motoshi
    Department of Hematology and Oncology, The University of Tokyo Hospital
  • YATOMI Yutaka
    Department of Clinical Laboratory, The University of Tokyo Hospital
  • KUROKAWA Mineo
    Department of Hematology and Oncology, The University of Tokyo Hospital

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Other Title
  • 本態性血小板血症から移行しアザシチジンが有効であった骨髄異形成症候群
  • 症例報告 第167回日本血液学会例会 : 水谷修紀例会長 推薦演題 本態性血小板血症から移行しアザシチジンが有効であった骨髄異形成症候群
  • ショウレイ ホウコク ダイ167カイ ニホン ケツエキ ガッカイ レイカイ : ミズタニシュウキ レイカイチョウ スイセン エンダイ ホンタイセイ ケッショウバン ケツショウ カラ イコウ シ アザシチジン ガ ユウコウ デ アッタ コツズイイケイセイ ショウコウグン

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Abstract

A 68-year-old woman with essential thrombocythemia had been treated with hydroxycarbamide and aspirin for 13 years. She exhibited the rapid progression of anemia, and a bone marrow examination showed dysplasia of the erythroid cells, myeloid cells, and megakaryocytes. Karyotype analysis indicated complex abnormalities including der (5;21)(p10;q10). She was diagnosed with myelodysplastic syndrome (MDS), refractory anemia with excess blasts-1 (RAEB-1). Lenalidomide was started, but no improvement in anemia was recorded. Lenalidomide was discontinued due to eosinophilia, basophilia, and a skin rash. Azacitidine was administered. The patient became transfusion independent, and a complete cytogenetic response was achieved with three courses of azacitidine. However, disease progression to acute myeloid leukemia (AML) was observed after an additional two courses of azacitidine, which was resistant to induction chemotherapy. The patient died five months later from AML transformation. Azacitidine may be effective in MDS transformed from essential thrombocythemia, and also in lenalidomide-resistant MDS with the deletion of 5q.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (5), 468-472, 2013

    The Japanese Society of Hematology

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