A Case of Myelodysplastic Syndrome in a Renal Transplant Recipient.
- Author:
Cheol Woo LEE
1
;
Moon Su KANG
;
Jin Kook KIM
;
Hyun Ah LEE
;
Won Suk CHU
;
You Kyoung LEE
;
Won Bae KIM
;
Min Sun PARK
;
Seung Duk HWANG
;
Hi Bahl LEE
Author Information
1. Department of Internal Medicine, Soon Chun Hyang University Medical College, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Myelodysplastic Syndrome;
Leukemic transformation;
Renal transplantation;
Immunosuppressive agents;
chromosomal abnormality
- MeSH:
Adult;
Allografts;
Anemia;
Azathioprine;
Biopsy;
Bone Marrow;
Bone Marrow Examination;
Chromosome Aberrations;
Chromosomes, Human, Pair 17;
Chromosomes, Human, Pair 5;
Cyclosporine;
Cytarabine;
Cytogenetics;
Diagnosis;
Drug Therapy, Combination;
Dyspnea;
Fatigue;
Granulocyte Colony-Stimulating Factor;
Granulocyte Precursor Cells;
Humans;
Hyperplasia;
Immunosuppressive Agents;
Kidney;
Kidney Transplantation;
Monosomy;
Myelodysplastic Syndromes*;
Pancytopenia;
Prednisolone;
Renal Dialysis;
Renal Insufficiency;
Sepsis;
Topotecan;
Transplantation*;
Transplants;
Trisomy
- From:Korean Journal of Nephrology
1999;18(1):204-209
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 44-year-old man treated with azathioprine, cyclosporine and prednisolone for 7.5 years after allogeneic renal transplantation was admitted because of exertional dyspnea, fatigue and pancytopenia which were found 3 months ago. He had been on hemodialysis for renal failure of unknown cause for 8 months before the renal transplantation. Bone marrow examination showed hypercellularity, erythroid hyperplasia and 7% of myeloblast, consistent with the diagnosis of myelodysplastic syndrome. Cytogenetic study showed chromosomal abnormalities:deletion of chromosome 5, monosomy 7, trisomy 8, monosomy 14 and deletion of chromosome 17. Immunosuppressive agents were discontinued and he was treated with transfusion, G-CSF, and combination chemotherapy including topotecan and Ara-C. Graft kidney function was normal before and after the treatment, but the clinical course was fatal because of leukemic transformation and eventually sepsis. Although therapy induced myelodysplastic syndrome was rare in renal allograft recipients, thorough evaluations including bone marrow biopsy and cytogenetic study are recommended in patients with anemia of unknown etiology.
