• Rie Ohba, Noriko Usui, Yuta Ito, Hirofumi Yamauchi, Tomohito Machishima, Hiroto Ishii, Ryoko Fukushima, Hiroki Yokoyama, Yuko Shiota, Yuichi Yahagi, Shingo Yano, Nobuaki Dobashi, and Keisuke Aiba.
• Department of Clinical Oncology and Hematology, The Jikei University Daisan Hospital.
• Rinsho Ketsueki. 2017 Jan 1; 58 (6): 601-606.

AbstractMyelodysplastic syndrome with myelofibrosis (MDS-F) is a disease with a poor prognosis, and patients with this condition are at an increased risk of engraftment failures after allogeneic hematopoietic stem cell transplantation (SCT). Azacitidine (AZA) is effective in high-risk MDS patients. However, the effects of AZA on MDS-F have not been elucidated. AZA was administered to a 62-year-old male with MDS-F for 7 days at a dose of 75 mg/m2. Hematological improvements were observed after only 1 course of treatment. No suitable donor was found through the Japan Marrow Donor Program; therefore, the patient underwent umbilical cord blood transplant (UCBT). Neutrophil engraftment was observed on day 21 after the transplant procedure. He developed acute graft versus host disease (GVHD) of the skin (stage 3/grade II), but it could be controlled using prednisolone. Chronic GVHD was not observed and he was discharged in good general condition on day 68. While treatment prior to allogeneic SCT of MDS-F has not been established, in the present case, the hematological improvement brought about by AZA likely contributed to the patient's positive response to UCBT.

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