Postleukemic dysmyelopoiesis

Kathy Foucar, William P. Vaughan, James O. Armitage, Shivanand Patil, Fred Dick, Judith E. Karp

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

The morphologic and clinical features of four patients who developed significant bone marrow and blood dyspoiesis after successful chemotherapy for acute nonlymphocytic leukemia (ANLL) are described. This postleukemic dyspoiesis developed 1‐6 months after leukemia induction therapy and persisted for 5‐20 months in a relatively stable state. This period of prolonged dyspoiesis was not associated with rising myeloblast counts or clinical evidence of relapse. Dyspoietic abnormalities developed while two patients were receiving maintenance chemotherapy; the other two patients received no maintenance therapy. The dyspoietic changes in these four patients greatly exceeded those noted in a control group of ANLL patients on maintenance chemotherapy. The morphologic features of postleukemic dysmyelopoiesis were similar to those described in preleukemic dysmyelopoietic disorders. Erythroid abnormalities included hyperplasia with ring sideroblasts, megalobalstic changes, and cytoplasmic PAS reactivity. Myeloid abnormalities consisted of left‐shifted granulopoiesis with hyper‐ and hyposegmentation; megakaryocytic abnormalities included hyperplasia with a predominance of hypolobulated forms. Three of the four patients eventually suffered relapse and have died. The fourth patient died of sepsis after 20 months of pancytopenia and hysmyelopoiesis. Theories to explain the development of postleukemic dysmyelopoiesis are presented which emphasize the possibility of drug‐induced leukemia cell differentiation. Cytogenetic studies will be necessary to establish any relationship between ANLL and the subsequent postleukemic dysmyelopoiesis.

Original languageEnglish (US)
Pages (from-to)321-334
Number of pages14
JournalAmerican Journal of Hematology
Volume15
Issue number4
DOIs
StatePublished - Dec 1983
Externally publishedYes

Keywords

  • dysmyelopoiesis
  • myelodysplasia
  • postleukemic changes

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Foucar, K., Vaughan, W. P., Armitage, J. O., Patil, S., Dick, F., & Karp, J. E. (1983). Postleukemic dysmyelopoiesis. American Journal of Hematology, 15(4), 321-334. https://doi.org/10.1002/ajh.2830150403