Development of dysmyelopoietic syndrome in a hairy cell leukemia patient treated with chlorambucil: cytogenetic and morphologic evaluation.
A splenectomized patient with hairy cell leukemia (HCL) who had received chemotherapy with a low-dose alkylating agent for 2 years developed dysmyelopoietic syndrome (DMPS), the first such case to be described. A portion of his marrow remained chronically involved with HCL, but the remainder evolved from being morphologically and karyotypically normal to involvement with DMPS, with cells having a bizarre karyotype. Three of four metaphase cells had consistent abnormalities, with a missing chromosome No. 5, structural rearrangements resulting in deletion of part of the long arm of chromosome No. 7, deletion of 2q, and a small ring chromosome; upon further clonal evolution, a translocation between chromosomes No. 12 and 15 and deletion of the long arm of chromosome No. 19 were seen. We therefore add HCL patients to the growing list of those at risk of developing a secondary hematologic malignant disease possibly due to cytotoxic therapy for their primary disorder.
D001853:Bone Marrow / Q000473:pathology; D002699:Chlorambucil / Q000009:adverse effects*; D002869:Chromosome Aberrations; D006801:Humans; D007621:Karyotyping; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D013156:Splenectomy
D002699:Chlorambucil