鉄芽球性貧血に急性骨髄性白血病を合併した1例

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タイトル別名
  • A Case of Sideroblastic Anemia Complicated by Acute Myeloblastic Leukemia
  • テツガキュウセイ ヒンケツ ニ キュウセイ コツズイセイ ハッケツビョウ オ

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A 26 year-old male was admitted to the Nagoya Ekisaikai Hospital with complaints of anemia and fever in April 1977. Prior to admission, the patient had been noted to have 3-year history of schizophrenia and refractory anemia associated with leukopenia.<br>Hematological findings on admission disclosed mild anemia with dimorphism and leukocytosis with 66% of abnormal cells. These abnormal cells, which were identified as myeloblasts, predominantly occupied bone marrow in cosistent with the diagnosis of acute myeloblastic leukemia. He was treated with multicombination chemotherapy including vincristine, Endoxan, 6 MP and prednisolone. Though he responded well to the chemotherapy with disappearance of leukemic cells from the peripheral blood and bone marrow, thrombocytopenia and hypochromic anemia persisted. Then, he was put on the intensive hematological study which showed elevated serum iron and ineffective erythropoiesis, demonstrating numerous ringed sideroblasts in the bone marrow. In the studies on heme synthesis, his erythroblasts showed markedly reduced δ-aminolevulinic acid synthetase activity. From these data, he was diagnosed sideroblastic anemia complicated by acute myeloblastic leukemia. Thereafter, he was treated with pyridoxine (50 mg daily) for one month without response. In Nov. 1977, he was transfered to the lunatic asylum because of aggravating schizophrenia, and died of recurrence of acute leukemia in Jan. 1978.<br>The findings of this case suggest that sideroblastic anemia can develop as the consequence of bone marrow stem cell disorder which leads to several types of cellular abnormalities.

収録刊行物

  • 臨床血液

    臨床血液 19 (11), 1531-1537, 1978

    一般社団法人 日本血液学会

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