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Pancytopenia and myeloid maturation arrest in an autologous stem cell transplant recipient

Bone Marrow Transplantation volume 46, pages 610–611 (2011)Cite this article

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Myeloid maturation arrest is a typical feature of myelodysplastic syndrome. The occurrence of such a finding in patients who earlier received anthracycline-based chemotherapy usually prompts the suspicion of therapy-related myelodysplastic syndrome. Here, we report a case of relapsed aggressive lymphoma that, after successful autologous hematopoietic stem cell transplant (HSCT), had progressive pancytopenia and myeloid maturation arrest in the BM. The final diagnosis turned out to be extrapulmonary tuberculosis (TB), and empirical anti-TB treatment resulted in the resolution of pancytopenia and the restoration of myeloid maturation. We review the literature and briefly discuss on the evaluation and management of patients with such unique features.

A 63-year-old diabetic male visited our hospital in June 2007 because of an enlarged neck mass, productive cough, and fever. Pulmonary TB and stage IIIB diffuse large B-cell lymphoma were diagnosed concurrently. After standard courses of rituximab-based combination immunochemotherapy and anti-TB therapy, complete remission was achieved for both lymphoma and pulmonary TB. Unfortunately, recurrence of lymphoma was noted 11 months later. Salvage chemotherapy resulted in a second remission and the patient underwent autologous HSCT successfully in March 2009. After engraftment, his Hb level and platelet count were maintained at around 8–9 g/100 mL and 50–60 × 109/L, respectively, whereas his WBC count was normal.

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Authors and Affiliations

  1. Division of Hematology Oncology, Department of Medicine, Chang Gung Memorial Hospital-Chiayi, Chiayi, Taiwan, ROC

    F-C Kuan, C-E Hwang, C-H Lu & C-C Chen

  2. Department of Pathology, Chang Gung Memorial Hospital-Chiayi, Chiayi, Taiwan, ROC

    P Y Lin & C-H Lu

  3. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, ROC

    C-C Chen

  4. Department of Nursing, Chang Gung Institute of Technology, Chiayi, Taiwan, ROC

    C-C Chen

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  1. F-C Kuan
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  2. P Y Lin
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Correspondence to C-C Chen.

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Kuan, FC., Lin, P., Hwang, CE. et al. Pancytopenia and myeloid maturation arrest in an autologous stem cell transplant recipient. Bone Marrow Transplant 46, 610–611 (2011). https://doi.org/10.1038/bmt.2010.155

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