Unsuspected Fanconi's Anemia and Bone Marrow Transplantation in Cases of Acute Myelomonocytic Leukemia

Abstract

To the Editor: Patients with Fanconi's anemia, a constitutional chromosomal-fragility syndrome in which hypoplastic anemia develops that is associated with diverse congenital abnormalities,¹ have an abnormally high risk of malignant disease, especially acute myelomonocytic leukemia.² The possibility of misdiagnosis in cases of Fanconi's anemia is considerable³; the hematologic features typical of the disorder may not develop in some cases until the third decade of life.⁴ Abnormally high levels of spontaneous chromosome breakage in cultured lymphocytes, bone marrow cells, or both are of great help in establishing the diagnosis.⁵ In very rare cases, acute myelomonocytic leukemia may be the first . . .