Sequential induction of aplastic anemia and acute leukemia by chloramphenicol.

Chloramphenicol is a widely used antibiotic. It is also well known to cause some potentially lethal complications such as aplastic anemia, acute leukemia and paroxysmal nocturnal haemoglobinuria Al though development of aplastic anemia is relatively more frequent, evidence in favour of acute leukemia caused by chloramphenicol is mostly circumstantial. Very rarely, aplastic anemia caused by chloramphenicol may degenerate into acute leukemia. We describe a case who developed aplastic anemia following chl oramphenicol treatment. Bone marrow done at that time was severely aplastic with no evidence of leukemia. Her bone marrow improved completely with resolution of pancytopenia. Six months later she was again found to have pancytopenia. Bone marrow examination this time confirmed her to be suffering from acute mycloid leukemia. This sequential development of aplastic anemia and acute leukemia carries some interesting pathogenetic implications.