Myelodysplastic syndrome associated with chronic valproic acid therapy: a case report and review of the literature.

This report is of a case of myelodysplastic syndrome occurring in a 63 year old female on long-term valproic acid therapy for seizure disorder. Valproic acid therapy is widely prescribed for seizure disorders and is often associated with thrombocytopenia, macrocytic anemia and a reversible dysmyelopoiesis. There are rare reports in the literature of acute myeloid leukemia arising in patients treated with valproic acid. This case represents the first case report of a cytogenetically confirmed myelodysplastic syndrome occurring in a patient on long term valproic acid therapy and further supports that valproic acid, a histone deacetylase inhibitor, may be leukemogenic.