Abstract
A 34 year old male was admitted because of cough and fever on 22 Jan. 1982. He was diagnosed to have Down's syndrome in childhood. He has used thinner for 16 years as painter. Hematological examination revealed Hb 5.9 g/dl, WBC 26,000 with 43% blasts, and platelet 3.7×104/cmm. Bone marrow speciemen showed nucleated cell count 11.2×104/cmm with 74.4% blasts. Peroxydase reaction of blasts was positive, but PAS and non-specific esterase stains were negative. Trisomy 21 and hypoploidy were found in chromosome study. The diagnosis of acute myelocytic leukemia (M1) was made.
The patient was treated with BH-AC·DP therapy which resulted in complete remission. Eleven months later, he was found in relapse with 56.4% blasts in bone marrow. He died of lung bleeding on 18 Dec. 1982. Autopsy revealed bleeding lesions in various organs. Incidence of leukemia and possible leukemogenic factors in adult Down's syndrome were discussed.
This was the second adult case reported in Japan.
