RESUMO
BACKGROUND: Hypoplastic acute leukemia is rare and most cases reported were of older age group. We reviewed our cases of hypoplastic acute leukemia and their hematologic and clinical findings. METHOD: The bone marrow biopsy slides and the reports of patients diagnosed as having acute leukemia during recent ten years were reviewed. The medical records of patients who had blast cells of greater than 30% and marrow cellularity less than or equal to 50% were reviewed. RESULTS: Of 308 patients analyzed, 17 (5.5%) fulfilled the above mentioned criteria. Ten patients were women and seven men. The median age was 44 with a range of 18-71. Chief complaints were fever, headache, general weakness and abdominal pain. Two patient presented hepatomegaly. One patient was diagnosed as granulocytic sarcoma. Ten patients were pancytopenic with median leukocyte count of 1,500/ L, hemoglobin of 8.3 g/dL, and platelet count of 27,000/ L. Circulating blast cells were 0-76%. FAB classification revealed one to be M0, three M1, seven M2, three M4, one M5, one M6 and one L1. Seven patients were not followed, and three were treated conservatively. Of seven patients receiving chemotherapy, four achieved durable complete remission. One achieved complete remission by using G-CSF. CONCLUSION: Most cases of reported hypoplastic acute leukemia were acute myelogenous leukemia of older age but our cases included leukemia of younger age and one acute lymphoblastic leukemia. Of seven patients who received chemotherapy, four achieved complete remission and one showed complete remission only by G-CSF.
Assuntos
Feminino , Humanos , Masculino , Dor Abdominal , Biópsia , Medula Óssea , Classificação , Tratamento Farmacológico , Febre , Fator Estimulador de Colônias de Granulócitos , Cefaleia , Hepatomegalia , Leucemia , Leucemia Mieloide Aguda , Contagem de Leucócitos , Prontuários Médicos , Contagem de Plaquetas , Leucemia-Linfoma Linfoblástico de Células Precursoras , Sarcoma MieloideRESUMO
A 26-year-old female was admitted for the evaluation of thrombocytopenia, who complained easy bruisy and multiple petechiae at 22 weeks of gestation. Bone marrow examination was recommended, but refused. Steroid therapy was tried under the impression of idiopathic thrombocytopenic purpura. But pancytopenia developed at 37 weeks of gestation. Considering aplastic anemia associated with pregnanacy, Caesarian section with supplementation of platelet rich plasma and packed red blood cells was done in order to terminate pregnancy. Bone marrow findings at 1 week after delivery were compatible with aplastic anemia. At 8 weeks after delivery, recovery of pancytopenia was noticed with normalization of bone marrow cellularity and maturation of hematopoietic cells.