Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2023; 11(28): 6908-6919
Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6908
Leukemic transformation during anti-tuberculosis treatment in aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome: A case report and review of literature
Nuan-Nuan Xiu, Xiao-Dong Yang, Jia Xu, Bo Ju, Xiao-Yun Sun, Xi-Chen Zhao
Nuan-Nuan Xiu, Xiao-Dong Yang, Jia Xu, Bo Ju, Xiao-Yun Sun, Xi-Chen Zhao, Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
Author contributions: Zhao XC developed the idea; Xiu NN and Yang XD analyzed the data and drafted the manuscript; Xiu NN, Yang XD, Xu J, Ju B and Sun XY participated in patient treatment; Zhao XC revised the manuscript; All the authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient to publish this case report and any accompanying laboratory data.
Conflict-of-interest statement: The authors have no conflicts of interest to declare that are relevant to the content of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xi-Chen Zhao, MD, Chief Physician, Department of Hematology, The Central Hospital of Qingdao West Coast New Area, No. 9 Huangpujiang Road, Qingdao 266555, Shandong Province, China. zhaoxichen2003@163.com
Received: June 29, 2023
Peer-review started: June 29, 2023
First decision: August 9, 2023
Revised: August 18, 2023
Accepted: September 6, 2023
Article in press: September 6, 2023
Published online: October 6, 2023
Processing time: 88 Days and 0.5 Hours
Core Tip

Core Tip: A Chinese female had a 6-year history of nonsevere aplastic anemia and a 2-year history of paroxysmal nocturnal hemoglobinuria. With aggravation of systemic inflammatory symptoms, severe pancytopenia developed, and her hemoglobinuria disappeared. Laboratory findings met the diagnostic criteria for “severe aplastic anemia.” Anti-tuberculosis treatment resulted in leukemic transformation after a short duration of hematological remission. This case study revealed that aggravated inflammatory stressors can repress normal and leukemic hematopoiesis, and relieved inflammatory stressors can facilitate penetration of neoplastic hematopoiesis, suggesting an inflammatory stress-fueled antileukemic mechanism.