Abstract
A case of primary acquired sideroblastic anemia terminated in acute myeloblastic leukemia is reported. The patient was a 39-year-old female, who had been treated as aplastic anemia for three years at another hospital. Laboratory examinations on admission disclosed hypochromic anemia with occasional macrocytes, elevated serum iron, increased Hb F level (4.3%), reduced δ-aminolevulinic acid synthetase activity, erythroid hyperplasia with many ringed sideroblasts and atypical blast cells up to 17 per cent in the bone marrow. At this stage, leukemic transformation in the near future was highly suggested. A large dose of Pyridoxine, folic acid or anabolic steroid (oxymetholone) were not effective. After one year and six months following the diagnosis of sideroblastic anemia, marked proliferation of myeloblasts in the marrow with appearance of leukemic cells in the peripheral blood was noted. Combined chemotherapy was not beneficial to induce remission and she died from pneumonia. Autopsy revealed wide-spread leukemic cell infiltration and hemosiderin deposits in the liver, spleen, pancreas and stomach.
