title: [Secondary myeloid/natural killer cell acute leukemia appeared in multiple myeloma treated with melphalan].
abstract: A 67-year-old woman was treated with MP-P therapy and combination chemotherapy for multiple myeloma IgG-lambda type. After the therapy for about three years, pancytopenia developed. Bone marrow aspiration study revealed a few of myeloma cell and many atypical cells showing promyelocytic feature. Chromosomal abnormality was 46, X, -X, +8, -13, +mar. CD33 and CD56 were positive, but CD16 and HLA-DR were negative. We diagnosed as multiple myeloma complicated with secondary myeloid/natural killer (NK) cell acute leukemia. After she had been treated with low dose etoposide for leukemia, she obtained complete remission. But since myeloma progressed and the amount of M protein was increased, she was treated with dexamethasone and low dose etoposide, resulting in a decrease in the amount of M protein. After that, because of leukemic cell re-proliferation, she was treated with etoposide. However, she died of sepsis due to severe myelosuppression. This case was interesting one in coexist of multiple myeloma and secondary myeloid/NK cell acute leukemia, and those affecting her clinical course each other.
authors.affiliation: Third Department of Internal Medicine, Kanazawa University School of Medicine.
authors.forename: H
authors.initials: H
authors.lastname: Kaya
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Yamazaki
authors.forename: I
authors.initials: I
authors.lastname: Kumabashiri
authors.forename: S
authors.initials: S
authors.lastname: Ohtake
authors.forename: T
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000209:etiology*; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D009101:Multiple Myeloma / Q000188:drug therapy*; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D005047:Etoposide; D003907:Dexamethasone; D011239:Prednisolone; D008558:Melphalan