A 68 year old man with rheumatoid arthritis developed marrow aplasia during D-penicillamine treatment. Recovery of granulopoiesis and erythropoiesis was ineffective with features of a secondary sideroblastic anaemia. Absence of megakaryopoiesis persisted. Therapeutic measures failed, and the patient finally died. These events illustrate a haematopoietic stem cell injury induced by D-penicillamine.