Lymphoblastic transformation of myelodysplastic syndrome
Palavras-chave:
Myelodysplastic syndrome, Acute lymphoblastic leukemia, Clonal evolutionResumo
As síndromes mielodisplásicas (SMD) são doenças clonais da célula progenitora do tecido hemotopoiético. Aproximadamente um terço dos casos evoluem para leucemia aguda, em geral de linhagem mielóide. Entretando, poucos casos de transformação para leucemia linfoblástica aguda (LLA) tem sido descritos. Os autores apresentam um caso de anemia refratária que transformou para LLA dois meses após o diagnóstico e que foi tratada, com sucesso, com quimioterapia convencional. Dois anos após, uma forma hiperfibrótica de SMD foi detectada que evoluiu, finalmente, para uma leucemia megacarioblástica aguda.O curso da SMD do caso presente apresenta evidências que a SMD pode envolver o precursor pluripotencial, presente na evolução clonal e documentada por sucessivas mudanças nos achados clínicos e hematológicos.
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