3-LINEAGE RESPONSE AFTER LONG-TERM THERAP Y FOR SEVERE APLASTIC-ANEMIA WITH RHUG-CSF - PLATELET-FUNCTION DISORDER AS PRELUDE TO A MYELODYSPLASTIC SYNDROME

We report on a patient with very severe aplastic anemia (SAA) unrespon sive to immunosuppressive therapy (cyclosporine A, ATG). Because no HL A-identical family or unrelated donor could be found, a trial with rec ombinant human granulocyte stimulating factor (G-CSF) was started. Thi s was followed by a rapid 3-lineage response with near-normal blood co unts and transfusion independence. A similar response was obtained by 2 further G-CSF cycles which were given for relapsing SAA after G-CSF withdrawal. Following the third cycle, an acquired platelet function d isorder was observed which preceded a myelodysplastic syndrome.