[Long-term myelodysplastic syndrome transformed into blastic leukemia]

A very rare case of myelodysplastic syndrome of long duration transformed into acute leukemia is reported. The syndrome presented with refractory anemia with ring sideroblasts and after eight years of favourable course abruptly turned into acute myelomonoblastic leukemia with a rapid fatal outcome caused by gram-negative sepsis. The disappearance of the ring-sideroblasts from the bone marrow is pointed out as a bad prognostic sign. Treatment of the myelodysplastic syndrome with small doses of cytosine arabinoside is discussed as well as the nonobligatory passing through the stage of a gradual increase of the blast cells before the transformation into acute leukemia.