Abstract
A 27-year-old woman exhibited progressive pancytopenia during cyclophosphamide pulse therapy for lupus nephritis and low-dose methotrexate therapy for severe arthralgia. Bone marrow aspiration revealed highly abnormal cell morphology, indicating therapy-related myelodysplastic syndrome. Pancytopenia and bone marrow cell morphology improved 3 months after discontinuation of cyclophosphamide. It is necessary to promptly examine bone marrow cell morphology and chromosomal aberration in cases with connective tissue diseases complicated by sudden cytopenia during immunosuppressive therapy with chemotherapeutic agents.
MeSH terms
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Adult
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Bone Marrow Cells / pathology
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects*
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Cyclophosphamide / therapeutic use
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Female
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Humans
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / adverse effects*
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Immunosuppressive Agents / therapeutic use
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Lupus Erythematosus, Systemic / complications*
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Lupus Erythematosus, Systemic / drug therapy*
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Lupus Nephritis / complications
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Lupus Nephritis / drug therapy
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Methotrexate / administration & dosage
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Methotrexate / adverse effects*
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Methotrexate / therapeutic use
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Myelodysplastic Syndromes / etiology*
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Pancytopenia / etiology
Substances
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Immunosuppressive Agents
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Cyclophosphamide
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Methotrexate