内容紹介
A Case in Which Chromosome 5q Deletion Syndrome Resistant to Lenalidomide Therapy Transformed to Refractory Anemia with Excess Blasts
Summary
An 80-year-old man was admitted to our hospital because of pancytopenia. Bone marrow examination revealed an increase in the number of dysplastic cells indicating trilineage dysplasia. A 5q13q31 deletion was the only genetic abnormality found, and consequently, 5q deletion syndrome was diagnosed. Although lenalidomide therapy was initiated, it had to be discontinued because of Stevens-Johnson syndrome, which occurred during the second course of treatment. There was no discernible hematological improvement, and bone marrow aspiration showed transformation to refractory anemia with excess blasts-2(RAEB-2)after lenalidomide therapy. However, by changing the therapy to azacitidine, cytogenetic remission was achieved.
要旨
症例は80歳,男性。汎血球減少のため当院へ受診となった。骨髄穿刺で3血球系の異型を認め,染色体分析で5q13q31の単独欠失を呈したことから5q-症候群の診断となった。lenalidomideを開始したが,2コース目にStevens-Johnson症候群を併発して血液学的改善は得られなかった。その後汎血球減少が進行し,RAEB-2の診断となった。azacitidine療法を施行したところ,細胞遺伝学的奏効が得られた。
目次
Summary
An 80-year-old man was admitted to our hospital because of pancytopenia. Bone marrow examination revealed an increase in the number of dysplastic cells indicating trilineage dysplasia. A 5q13q31 deletion was the only genetic abnormality found, and consequently, 5q deletion syndrome was diagnosed. Although lenalidomide therapy was initiated, it had to be discontinued because of Stevens-Johnson syndrome, which occurred during the second course of treatment. There was no discernible hematological improvement, and bone marrow aspiration showed transformation to refractory anemia with excess blasts-2(RAEB-2)after lenalidomide therapy. However, by changing the therapy to azacitidine, cytogenetic remission was achieved.
要旨
症例は80歳,男性。汎血球減少のため当院へ受診となった。骨髄穿刺で3血球系の異型を認め,染色体分析で5q13q31の単独欠失を呈したことから5q-症候群の診断となった。lenalidomideを開始したが,2コース目にStevens-Johnson症候群を併発して血液学的改善は得られなかった。その後汎血球減少が進行し,RAEB-2の診断となった。azacitidine療法を施行したところ,細胞遺伝学的奏効が得られた。