Fukushima J. Med. Sci., Vol. 56, No. 2, 2010
[Case Report]
THERAPY-RELATED MYELODYSPLASTIC SYNDROME FOLLOWING CYCLOPHOSPHAMIDE PULSE AND/OR METHOTREXATE THERAPY IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS
HARUYO IWADATE1), HIROKO KOBAYASHI1), KIORI YANO1), HIROSHI WATANABE1), KAZUHIKO IKEDA2), KAZUEI OGAWA2) and HIROMASA OHIRA1)
1)Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan, 2)Department of Cardiology and Hematology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
(Received December 16, 2009, accepted May 13, 2010)
Abstract: A 27-year-old woman exhibited progressive pancytopenia during cyclophosphamide pulse therapy for lupus nephritis and low-dose methotrexate therapy for severe arthralgia. Bone marrow aspiration revealed highly abnormal cell morphology, indicating therapy-related myelodysplastic syndrome. Pancytopenia and bone marrow cell morphology improved 3 months after discontinuation of cyclophosphamide. It is necessary to promptly examine bone marrow cell morphology and chromosomal aberration in cases with connective tissue diseases complicated by sudden cytopenia during immunosuppressive therapy with chemotherapeutic agents.
Key words: cyclophosphamide, therapy-related myelodysplastic syndrome, systemic lupus erythematosus
岩舘治代，小林浩子，矢野季織，渡辺浩志，池田和彦，小川一英，大平弘正
Corresponding author: Haruyo Iwadate, M.D.
E-mail address: haru-i@fmu.ac.jp
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