M. Yasuda et al., TRILINEAGE RESPONSE TO RHG-CSF WITH SUBSEQUENT CLONAL HEMATOPOIESIS IN A PATIENT WITH SEVERE BONE-MARROW APLASIA, Leukemia & lymphoma, 14(3-4), 1994, pp. 347-351
We treated a patient with severe aplastic anemia with long-term admini
stration of recombinant human granulocyte-colony stimulating factor (r
hG-CSF). When a trilineage response of hematopoiesis was obtained afte
r the first treatment, a chromosomal change [45XX, -7] was observed in
20 of the 20 metaphases examined. Later, we were able to show a monoc
lonal X inactivation pattern in the phosphoglycerate kinase (PGK) gene
in the peripheral blood polymorphonuclear leukocytes and mononuclear
cells, indicating the presence of clonal hematopoiesis regardless of t
he disappearance of the karyotype abnormality. We suggest that it is i
mportant to pay close attention to the appearance of clonal hematopoie
sis during the administration of G-CSF to patients with idiopathic sev
ere bone marrow aplasia.