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July 1980

Myelodyspoietic Syndrome Associated With Diethylstilbestrol Therapy

Arch Intern Med. 1980;140(7):976-977. doi:10.1001/archinte.1980.00040020976021

We describe a patient with a myelodysplastic syndrome characterized by pancytopenia and an excess of myeloblasts in the bone marrow. He had received massive doses of diethylstilbestrol (150 mg daily) for seven years as therapy for prostatic carcinoma. Although myelodyspoiesis has been associated with other drugs, a relationship to estrogen therapy in man has not been reported previously. However, the administration of estrogens to animals has produced pancytopenia with a relative monocytosis and vacuolization of leukocytes. Examination of bone marrow specimen from such animals has revealed hyper-cellularity, myeloid hyperplasia, erythroid hypoplasia, and, with prolonged therapy, aplastic anemia. Further animal studies have demonstrated that estrogens exert a suppressive effect on marrow stem cells and granuloid progenitor cells. These experimental observations suggest a possible role of estrogens in the genesis of the hematologic changes we observed.

(Arch Intern Med 140:976-977, 1980)