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Clinical Brief
Acute Myeloid Leukemia With Severe Aplastic Anemia Following Immunosuppressive Therapy Sameer Bakhshi, Ajay Gupta and Lalit Kumar Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi
ABSTRACT Severe aplastic anemia (AA) is a life-threatening condition wherein bone marrow transplantation (BMT) is the therapy of choice in a young patient who has a matched sibling donor. Here, we report an 11-year-old boy with severe AA who was referred for BMT late in its course when he had developed acute myeloid leukemia following two courses of immunosuppressive therapy with antithymocyte globulin and cyclosporin. He was then treated with induction therapy using cytosine arabinoside and daunomycin for acute myeloid leukemia, but he succumbed due to infection and refractory leukemia. We discuss the relevance of early referral for BMT in severe AA. [Indian J Pediatr 2006; 73 (11) : 1033-1035] E-mail:
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Key words : Aplastic anemia; Bone marrow transplantation; Immunosuppressive therapy; Leukemia
Aplastic anemia (AA) is a potentially life-threatening failure of hemopoiesis characterized by pancytopenia and bone marrow aplasia. Classification of AA depends on degree of peripheral blood pancytopenia. Severe AA is defined by bone marrow cellularity < 25% and very low values of at least 2/3 hemopoietic lineages: absolute neutrophil count (ANC) < 500/mm 3, platelet count
