ACETAZOLAMIDE-INDUCED SEVERE PANCYTOPENIA MIMICKING MYELODYSPLASIA RELAPSE FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION

Pancytopenia with severe bone marrow dysplasia following allogeneic bo ne marrow transplantation for acute myeloid leukemia (M6) may pose a d iagnostic problem. We report a case of M6 acute myeloid leukemia in wh ich progressive macrocytosis, pancytopenia and severe bone marrow dysp lasia induced by acetazolamide therapy developed after successful engr aftment of a donor marrow. We discuss the diagnostic problems and the usefulness of conventional cytogenetics and interphase fluorescence in situ hybridisation in excluding recipient myelodysplasia relapse. We also suggest that acetazolamide should be used with caution, especiall y following bone marrow transplantation.