A CASE OF NON-HODGKIN'S LYMPHOMA DEVELOPED MICROANGIOPATHIC HEMOLYTIC ANEMIA WITH ATYPIA OF BONE MARROW CELLS FOLLOWING AUTOLOGOUS PERIPHERAL BLOOD STEM CELL TRANSPLANTATION

Abstract

A 49-years-old male with non-Hodgkin's lymphoma underwent autologous peripheral blood stem cell transplantation (PBSCT) in the 2 nd remission. Hematopoietic reconstitution was rapid. Methotrexate (25 mg) was injected on the 22 day after PBSCT, because of swelling of a paraaortic lymphnode. Thrombocytopenia, hemolytic anemia, and occult blood of urine emerged 2 months after PBSCT. Coomb's test was negative and no sign of DIC was seen. Schistocytes appeared in the blood smear. Bone marrow examination showed diploid nuclei erythroblasts, hypersegmented megakaryocytes and giant metamyelocytes. Medication of steroid did not show rapid effect and transfusion was needed, 9 months after PBSCT hematopoietic reconstitution was observed. This case is noteworthy of re-porting because it seemed to be an oppotunistic case of microangiopathic hemolytic anemia following autoPBSCT, presenting myelodysplastic syndrome-like dysplasia of bone marrow cells.