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Erythroleukemia‐like syndrome due to busulfan toxicity in polycythemia vera
Author(s) -
Pezzimenti John F.,
Kim H. Chul,
Lindenbaum John
Publication year - 1976
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197612)38:6<2242::aid-cncr2820380608>3.0.co;2-g
Subject(s) - busulfan , medicine , pancytopenia , polycythemia vera , thrombocytosis , splenectomy , gastroenterology , bone marrow , phlebotomy , hemolysis , hydroxycarbamide , surgery , chemotherapy , platelet , spleen , cyclophosphamide
Over a 19‐year period, a patient with polycythemia vera who had undergone a splenectomy received six courses of busulfan for recurrent thrombocytosis. The total dose of busulfan given for the sixth course was greater than that used for the previous ones. Severe pancytopenia followed, which persisted for 4 months. During this period there was marked erythroid hyperplasia in the bone marrow with striking dyserythropoiesis; PAS‐positive red cell precursors, as well as moderate numbers of circulating normoblasts and evidence of chronic and acute hemolysis, were present. All of these findings reverted to normal without therapy, and the polycythemic state eventually recurred. These events are interpreted as an unusual marrow reaction following busulfan overdosage rather than a transient erythroleukemia.