Aplastic Anemia converting to AML?

[Mary C]

My dad was diagnosed in November 2007 with AA and was treated with ATG, Cyclosporin,Neupogen and Aranesp. Had bone marrow bx. done this week - now diagnosed with AML. I knew this was possible, but wondering if anyone else out there has had experience with it happening so quickly (< 3months)?

[Dan2008]

Hi Mary,

I am very sorry about your father's diagnosis. Sometimes the marrow at biopsy appears empty and it resembles AA. It is not necessary an error in diagnosis, because the marrow is empty and it is identical to an AA marrow. Probably the leukemic cells trigger an immune response which suppresses the normal marrow. As the immunosuppressive treatment is started, the normal marrow comes back, but the leukemic cells surface too, making the diagnosis of AML obvious. Again, it is not necessary a diagnostic error, but rather an atypical presentation for AML. Our doctor made us aware of this possibility.

Dan

[Mary C]

Thanks for your reply, Dan. That certainly makes sense. We did know that the docs had a hard time calling the dx. (toss up between AA and MDS) back in November - just so few cells there to really evaluate.

In the grand scheme of things...I know it doesn't make much difference. Dad is very fortunate not to have acquired any infections and of course they have been following his blood numbers very closely. I think his doctor was surprised at the bone marrow bx. report because Dad has not been symptomatic as one would have expected with AML.

Mary