Prolonged bone marrow failure with monosomy 7 after engraftment failure following bone marrow transplantation

A patient with acute myelogenous leukemia developed prolonged bone marrow f ailure along with the monosomy 7 chromosome abnormality. The patient had un dergone bone marrow transplantation with CD34(+) selection following induct ion failure. However, she then suffered engraftment failure and long-term p ancytopenia. Her white blood cell count gradually increased with supportive therapy including granulocyte colony-stimulating factor (G-CSF), and chrom osomal analysis of bone marrow cells revealed an abnormal karyotype. Thirty months after the bone marrow transplantation we observed monosomy 7 togeth er with the existing chromosomal abnormality in the patient's bone marrow c ells. It has been reported that some patients with idiopathic and posthepat itis aplastic anemia develop clonal disorders such as myelodysplastic syndr ome/acute myelogenous leukemia with monosomy 7. The findings in our case su ggest that the appearance of monosomy 7 in patients with aplastic anemia ma y be caused by prolonged low-level hematopoiesis, with or without G-CSF sti mulation. (C) 2001 The Japanese Society of Hematology.