Transformation of aplastic anemia to acute myeloid leukemia in a Chinese adult after 16 years

Aplastic anemia (AA) is a potentially life-threatening failure of hemopoiesis defined as pancytopenia and an empty bone marrow. It is a more common disease in Asia than in the west with the annual incidence in china of 7.4 per million in contrasts to 2.34 per million in Europe and Israel (1 2). Clonal hematopoiesis has been related to AA, including paroxysmal nocturnal hemoglobinuria (PNH), myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) (3). The true incidence of acute leukemia after AA in China is not known but appears to be rare. Here, we report a case of aplastic anemia evolving into acute myeloid leukemia (AML) after 16 years.