Implication of prior treatment with drug combinations including inhibitors of topoisomerase II in therapy-related monocytic leukemia with a 9;11 translocation.
The present case, together with other reports reviewed herein, defines a new subtype of therapy-related acute myeloid leukemia (t-AML). This variant of t-AML is characterized by a short interval from initial drug therapy to bone marrow dysfunction and monocytic morphology without trilineage dysplasia. Unlike classic t-AML, which frequently has abnormalities of chromosomes 5 and/or 7, this new subtype is characterized by rearrangements involving band q23 of chromosome 11, most commonly a 9;11 translocation. The majority of patients with this subtype t-AML had prior cytotoxic therapy with topoisomerase II-reactive drugs including anthracyclines, epipodophyllotoxins, or actinomycin D, combined with either an alkylating agent or cisplatin. This association of prior therapy which includes topoisomerase II-reactive agents and a rapidly appearing t-AML involving the monocytic line and chromosome 11 requires additional study.
Albain
K S
KS
Department of Medicine, Loyola University Stritch School of Medicine, Maywood, IL 60153.
Le Beau
M M
MM
Ullirsch
R
R
Schumacher
H
H
D000477:Alkylating Agents / Q000009:adverse effects; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D002880:Chromosomes, Human, Pair 11 / Q000648:ultrastructure*; D002899:Chromosomes, Human, Pair 9 / Q000648:ultrastructure*; D002945:Cisplatin / Q000009:adverse effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003609:Dactinomycin / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D007948:Leukemia, Monocytic, Acute / Q000139:chemically induced* / Q000145:classification / Q000235:genetics; D015409:Mastectomy, Radical; D008875:Middle Aged; D011034:Podophyllotoxin / Q000009:adverse effects; D011878:Radiotherapy; D013629:Tamoxifen / Q000008:administration & dosage; D059005:Topoisomerase II Inhibitors; D014178:Translocation, Genetic
D000477:Alkylating Agents; D000903:Antibiotics, Antineoplastic; D059005:Topoisomerase II Inhibitors; D013629:Tamoxifen; D003609:Dactinomycin; D004317:Doxorubicin; D003520:Cyclophosphamide; D011034:Podophyllotoxin; D002945:Cisplatin