title: 11q23 aberration is an additional chromosomal change in de novo acute leukemia after treatment with etoposide and mitoxantrone.
abstract: We report on 2 patients with acute leukemia who had an 11q23 chromosomal aberration as an additional change after treatment with etoposide and mitoxantrone, agents that affect topoisomerase II (Topo II). One patient with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (L2) received chemotherapy, including 1,000 mg of etoposide and 75 mg of mitoxantrone. She relapsed 10 months later. Analysis at time of relapse showed a chromosomal aberration of del(11)(q23) as an additional cytogenetic change. The other patient was diagnosed with acute monoblastic leukemia (M5a) and received two autologous peripheral blood stem-cell transplantations. Her cumulative doses of etoposide and mitoxantrone were 6,000 mg and 42 mg, respectively. She also relapsed, and analysis at that time revealed del(11)(q23) as an additional chromosomal aberration. The mixed lineage leukemia/myeloid-lymphoid leukemia (MLL) gene was not rearranged in either case, making these cases distinct from previously described therapy-related leukemias caused by Topo II inhibitors. Based on these two cases, it may be that Topo II inhibitors can cause clonal evolution affecting chromosome band 11q23.
authors.affiliation: Third Department of Internal Medicine, Akita University School of Medicine, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ohshima
authors.forename: I
authors.initials: I
authors.lastname: Miura
authors.forename: A
authors.initials: A
authors.lastname: Chubachi
authors.forename: K
authors.initials: K
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Nimura
authors.forename: S
authors.initials: S
authors.lastname: Utsumi
authors.forename: N
authors.initials: N
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
authors.forename: M
authors.initials: M
authors.lastname: Seto
authors.forename: R
authors.initials: R
authors.lastname: Ueda
authors.forename: A B
authors.initials: AB
authors.lastname: Miura
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D002880:Chromosomes, Human, Pair 11 / Q000187:drug effects / Q000648:ultrastructure*; D004250:DNA Topoisomerases, Type II / Q000502:physiology; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D005047:Etoposide / Q000008:administration & dosage / Q000494:pharmacology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007621:Karyotyping; D007948:Leukemia, Monocytic, Acute / Q000188:drug therapy / Q000235:genetics*; D008942:Mitoxantrone / Q000008:administration & dosage / Q000494:pharmacology*; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors* / Q000502:physiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000235:genetics*; D059005:Topoisomerase II Inhibitors
chemical_list: D004791:Enzyme Inhibitors; D009363:Neoplasm Proteins; D059005:Topoisomerase II Inhibitors; D005047:Etoposide; D008942:Mitoxantrone; D004250:DNA Topoisomerases, Type II