内容紹介
Myelodysplastic Syndrome with Rapid Disease Progression after Withdrawal of Treatment with Azacitidine
Summary
A 73-year-old woman was diagnosed with myelodysplastic syndrome(MDS). After 11 courses of treatment with azacitidine(AZA), her hemoglobin level and platelet count improved significantly, and she became transfusion independent. Therefore, treatment was discontinued and follow-ups were maintained. Three months later, her platelet count reduced again; we therefore treated her again with AZA. However, MDS transformed to acute myeloid leukemia in the 14th course, and she died 19 months after the initial diagnosis. AZA is an important drug for treating MDS, but premature withdrawal of treatment might cause rapid disease progression. In case treatment is discontinued, the patient needs to be carefully observed.
要旨
症例は骨髄異形成症候群(myelodysplastic syndrome: MDS)と診断された73歳,女性。アザシチジン(azacitidine: AZA)療法11コース目後にHb,血小板数の増加が認められ,輸血が不要となった。本人の希望により治療を一時中止して経過観察していたが,3か月後に血小板数が減少したためAZA療法を再開した。しかしながら,14コース目に急性骨髄性白血病への進行が認められ,診断から19か月後に永眠された。AZAはMDSの治療に重要な薬剤であるが,その中断は急速な病勢悪化をもたらす危険性があり,中断症例は注意深い経過観察が必要である。
目次
Summary
A 73-year-old woman was diagnosed with myelodysplastic syndrome(MDS). After 11 courses of treatment with azacitidine(AZA), her hemoglobin level and platelet count improved significantly, and she became transfusion independent. Therefore, treatment was discontinued and follow-ups were maintained. Three months later, her platelet count reduced again; we therefore treated her again with AZA. However, MDS transformed to acute myeloid leukemia in the 14th course, and she died 19 months after the initial diagnosis. AZA is an important drug for treating MDS, but premature withdrawal of treatment might cause rapid disease progression. In case treatment is discontinued, the patient needs to be carefully observed.
要旨
症例は骨髄異形成症候群(myelodysplastic syndrome: MDS)と診断された73歳,女性。アザシチジン(azacitidine: AZA)療法11コース目後にHb,血小板数の増加が認められ,輸血が不要となった。本人の希望により治療を一時中止して経過観察していたが,3か月後に血小板数が減少したためAZA療法を再開した。しかしながら,14コース目に急性骨髄性白血病への進行が認められ,診断から19か月後に永眠された。AZAはMDSの治療に重要な薬剤であるが,その中断は急速な病勢悪化をもたらす危険性があり,中断症例は注意深い経過観察が必要である。