title: [A case of secondary leukemia in anaplastic seminoma patient treated with long-term chemotherapy].
abstract: A 46-year-old man had received a long-term induction plus salvage chemotherapy for anaplastic seminoma with stage IV disease. Chemotherapy regimens and cycles included the following; four cycles of bleomycin plus vinblastine plus cisplatin (BVP); eight cycles of cyclophosphamide, vincristine, and cisplatin (COP); three cycles of etoposide plus cisplatin (EP); thirteen cycles of etoposide with ifosfamide and cisplatin (VIP). The total cumulative dose of etoposide was 4250 mg/m2. Severe and persistent pancytopenia developed 32 months after starting etoposide-based salvage chemotherapy. Bone marrow examination showed hypercellular marrow containing 68% myeloblasts but peroxidase reaction was negative. CD-13 was 30.1% which meant that leukemia was myelogenous. Therefore, he was diagnosed as acute myelogenous leukemia. French-American-British classification was MO. Chromosome analysis revealed a t (8; 21)(q22;q22) cytogenetic abnormality. This case may be compatible with the clinical and cytogenetic characters of epipodophyllotoxin-related leukemia. We conclude that high doses of etoposide seem to be leukemogenic. To our knowledge, this is the first reported case in the literature relevant to epipodophyllotoxin-related secondary leukemia in testicular tomor in Japan.
authors.affiliation: Department of Urology, Showa General Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kamai
authors.forename: T
authors.initials: T
authors.lastname: Touma
authors.forename: H
authors.initials: H
authors.lastname: Masuda
authors.forename: N
authors.initials: N
authors.lastname: Hyouchi
authors.forename: T
authors.initials: T
authors.lastname: Okuno
authors.forename: J
authors.initials: J
authors.lastname: Yonese
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
authors.forename: Y
authors.initials: Y
authors.lastname: Tachibana
authors.forename: D
authors.initials: D
authors.lastname: Ishiwata
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005047:Etoposide / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced*; D011034:Podophyllotoxin / Q000009:adverse effects; D018239:Seminoma / Q000188:drug therapy*; D013736:Testicular Neoplasms / Q000188:drug therapy*
chemical_list: D005047:Etoposide; D011034:Podophyllotoxin