EVOLUTION OF SEVERE APLASTIC-ANEMIA TO MYELODYSPLASIA WITH MONOSOMY-7FOLLOWING GRANULOCYTE-COLONY-STIMULATING FACTOR, ERYTHROPOIETIN AND HIGH-DOSE METHYLPREDNISOLONE COMBINATION THERAPY

A 19-year-old man was diagnosed as having severe aplastic anemia and r eceived high-dose methylprednisolone treatment without hematological r esponse, A second course of high-dose mPSL treatment together with gra nulocyte colony-stimulating factor (G-CSF) plus erythropoietin (EPO) w as then started and resulted in trilineage blood cell response, Ten mo nths after the combination therapy thrombocytopenia developed and cyto genetic analysis showed 45,XX,-7, indicating an evolution to myelodysp lastic syndrome (MDS) associated with monosomy 7, G-CSF and EPO treatm ent together with immunosuppression may be an effective therapy in SAA patients, but such a therapy may increase the risk of evolution to MD S.