Abstract
A 12-year-old boy of preleukemia is reported. He visited to our outpatient clinic with complaints of exertional dyspnea and ecchymoses in August, 1974. On physical examination frank anemia and ecchymoses were found. Initial blood study revealed a Hb of 5.5g/dl, hematocrit of 18%, erythrocytes of 161×104/mm3, reticulocytes of 1.1%, platelets of 2.7×104/mm3, and leukocytes of 3,700/mm3 with neutropenia. Moderate anisopoikilocytosis was shown on the blood smear. The bone marrow was hyperplastic and characterized by maturation arrest of the myeloid series and bizarre nuclei of erythroblasts. The oxymetholone therapy, 60mg daily, was given to result in nearly normal hematologic findings in five months, and was discontinued in August, 1975. A mild anemia, moderate to severe leukopenia and thrombocytopenia again developed in Feburary, 1976, which showed only an inadequate response to the oxymetholone therapy. In October of the same year, myeloblasts began to increase in the bone marrow and were occasionally detected in the peripheral blood. A cytogenetic study at this stage revealed hyperdiploidy in 94% of mitotic figures examined, the mode of chromosome number being 50. Subsequently, the patient took a rapid downhill course, and died of sepsis due to E. coli in December, 1976.
