Many diseases can be interconverted with each other, as shown by the fact that related diseases in hematology such as reblastosis, paroxysmal sleep hemoglobinuria (PNH), and myelodysplastic syndrome (MDS) can be interconverted with each other, especially the first two, which are not only difficult to differentially diagnose, but also can be interconverted in the treatment process. However, in a recent case, the patient was diagnosed with severe aplastic anemia 4 years ago in our hospital and did not choose allogeneic hematopoietic stem cell transplantation and ATG/ALG treatment for various reasons. That is, the bone marrow has been transformed to acute leukemia! Once the disease has progressed to this stage, the treatment options are limited: chemotherapy and allogeneic HSCT. Unfortunately, the next step is to start treatment as soon as possible since the disease has clearly transformed into acute leukemia! Min Zhang, Department of Hematology, Wuhan Union Medical College Hospital
This case reminds us that in clinical work, we should consider the problem as comprehensively as possible, review bone marrow cytology and other related examinations regularly, communicate fully with the patient and family, and treat in strict accordance with the indications and medical principles to detect and solve the problem as early as possible!