Therapy-related acute myelomonocytic leukemia following successful treatment for acute promyelocytic leukemia.
We report a case of therapy-related acute myeloid leukemia (t-AML), M4 FAB subtype, with t(10;11)(p14;q21) chromosome abnormality developed in a patient treated for acute promyelocytic leukemia (APL) after 4 years of continuous complete remission (CCR). Two distinct forms of t-AML have been described: the classical type and the second type. Our case has many characteristics in common with the second type of t-AML such as: exposure to topoisomerase II active agents (idarubicin (IDA), mitoxantrone (MITOX), etoposide (VP16)), M4 FAB subtype, a latency period of 39 months and absence of a preleukemic phase. However, it differs in the chromosome 11 breakpoint (band q21 instead of q23) and absence of ALL-1 (Hrx, MLL, Htrx) gene involvement. This can represent the second observation of t-AML occurring after treatment for APL.
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Department of Human Biopathology, University, La Sapienza, Rome, Italy.
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Amadori
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Mandelli
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D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002879:Chromosomes, Human, Pair 10 / Q000235:genetics*; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics*; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D003561:Cytarabine / Q000009:adverse effects; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000009:adverse effects; D007621:Karyotyping; D015479:Leukemia, Myelomonocytic, Acute / Q000139:chemically induced* / Q000188:drug therapy / Q000235:genetics; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000235:genetics; D015122:Mercaptopurine / Q000009:adverse effects; D008727:Methotrexate / Q000009:adverse effects; D008942:Mitoxantrone / Q000009:adverse effects; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000188:drug therapy / Q000235:genetics; D012074:Remission Induction; D013866:Thioguanine / Q000009:adverse effects; D014178:Translocation, Genetic
D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone; D015122:Mercaptopurine; D013866:Thioguanine; D008727:Methotrexate; D015255:Idarubicin