MYELODYSPLASTIC CHANGES IN 3 CASES WITHIN 100 DAYS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

Three patients with severe aplastic anemia, acute promyelocytic leukem ia (M3) and chronic myelogenous leukemia, developed myelodysplastic ch anges with trilineage morphological abnormalities in a few months foll owing allogeneic bone marrow transplantation (BMT). Morphologically dy splastic changes associated with moderate-severe anemia, leukopenia an d/or thrombocytopenia appeared on day 40, day 62 and day 68 after BMT. A ferrokinetics study clearly showed ineffective erythropoiesis in on e patient. Hematopoietic cells were shown to be of donor-origin in all three cases. The levels of vitamin B12 and folic acid were normal. La boratory tests showed no signs of hemolysis or fragmentation of red bl ood cells. Although the cause of aberrant hematopoiesis compatible wit h MDS within 100 days post-BMT remains to be determined, cytomegalovir us infection, ganciclovir and/or graft-versus host disease(GVHD) might be associated with this myelodysplasia following allogeneic BMT.