Idiopathic refractory sideroachrestic anemia (IRSA) progressing to acute mixed lymphoblastic-myelomonoblastic leukemia

Case report and review of the literature


A longitudinal observation of a patient with idiopathic refractory sideroachrestic anemia (IRSA) progressing to acute mixed lymphoblastic-myelomonoblastic leukemia is reported. The leukemia was characterized by morphology, immunological cell markers, and dissociated clinical responsiveness to vincristine/prednisone and arabinosylcytosine/6-thioguanine. Attention is paid to the hematological changes prior to leukemia development. Acute leukemia was best heralded in this patient by a severe deterioration of dyserythropoiesis and by an increase of blasts in the marrow to more than 5%. The observed preleukemic features are compared to those described in the literature.

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Correspondence to R. Hehlmann.

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Supported in part by the Deutsche Forschungsgemeinschaft (SFB 51)

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Hehlmann, R., Zönnchen, B., Thiel, E. et al. Idiopathic refractory sideroachrestic anemia (IRSA) progressing to acute mixed lymphoblastic-myelomonoblastic leukemia. Blut 46, 11–21 (1983).

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Key words

  • Idiopathic refractory sideroachrestic anemia
  • Sideroblastic anemia
  • Acute mixed lymphoblastic myelomonoblastic leukemia
  • Preleukemia