抄録
A 56-year-old man was admitted to the Akita University Hospital because of a giant hematoma in the left side of his chest in December 1977. The platelet count on admission was 315.9×104/mm3, and the bone marrow aspiration and biopsy revealed marked increase in number of megakaryocytes. The Philadelphia chromosome was negative. Diagnosis of essential thrombocythemia was made. Phlebotomy, Busulfan, 32P and ACNU were used to decrease the platelet count. The platelet level was maintained less than 100×104/mm3 and leukocyte count was about 2.0×104/mm3 during one year.
In April 1979, the platelet count was suddenly decreased to 23.2×104/mm3 and leukocyte count was 5,400/mm3, with 13% blast cells. Under the diagnosis of acute myeloblastic leukemia (M1), induction therapy was repeatedly done for 8 months, but a complete remission was not achieved. He died of sepsis at December 21, 1979. A postmortem examination revealed acute myelogenous leukemia associated with early mild myelofibrosis, moderate hepatosplenomegaly and bilateral chronic hemorrhagic pneumonia caused by aspergillus and serratia.
