title: Chronic myelomonocytic leukemia following prolonged alkylating agent therapy for multiple myeloma.
abstract: A 35-year-old male presented with chronic myelomonocytic leukemia (CMMoL) after 6.5 years of alkylating agent therapy for IgG-kappa type multiple myeloma. The total dose of melphalan was 0.648 g. CMMoL was stable with weekly injection of alpha-interferon for one year. Thereafter, monocytosis and thrombocytopenia aggravated, and the patient died of disseminating intravascular coagulation. Prolonged drug therapy can induce CMMoL, as well as other myelodysplastic syndromes.
authors.affiliation: Department of Medicine, Kobe University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Natazuka
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Murayama
authors.forename: M
authors.initials: M
authors.lastname: Fukase
authors.forename: T
authors.initials: T
authors.lastname: Matsui
authors.forename: T
authors.initials: T
authors.lastname: Isobe
authors.forename: K
authors.initials: K
authors.lastname: Chihara
mesh_terms: D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D006801:Humans; D015477:Leukemia, Myelomonocytic, Chronic / Q000139:chemically induced*; D008297:Male; D008558:Melphalan / Q000009:adverse effects*; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D009190:Myelodysplastic Syndromes / Q000139:chemically induced; D016609:Neoplasms, Second Primary / Q000139:chemically induced*
chemical_list: D008558:Melphalan