title: Transient therapy-related myelodysplastic syndrome associated with monosomy 7 and 11q23 translocation.
abstract: Secondary acute myelocytic leukemia (AML) and myelodysplastic syndromes (MDS) are known to develop in patients previously treated with different chemotherapeutic regimens. Nonrandom chromosomal abnormalities have been demonstrated in these therapy-related myeloid disorders which often evolve into refractory AML. The prognosis of these patients with conventional chemotherapy has been dismal and only allogeneic bone marrow transplantation offers a potential cure. We describe two patients who developed MDS after chemo/radiotherapy and had a spontaneous recovery. One patient was treated with MOPP-ABVD hybrid therapy for Hodgkin's disease, developed pancytopenia, marrow hypoplasia and dyserythropoiesis associated with monosomy 7. The other was treated with a combination of chemotherapy including VP-16 for Ewing's sarcoma, developed thrombocytopenia, marrow hypoplasia and dyserythropoiesis associated with an 11q23 translocation. Both patients received rhG-CSF after their cycles of chemotherapy and were considered for a bone marrow transplant. Marrow aspirates at frequent intervals showed gradual disappearance of the abnormal clone with parallel normalization of the peripheral count. In both patients G-CSF might have played a role in the development of the abnormal clone. We suggest that patients with therapy-related MDS without excess of blasts could be closely monitored for karyotypic and hematological improvement rather than transplanted immediately.
authors.forename: J H
authors.initials: JH
authors.lastname: Laver
authors.forename: U
authors.initials: U
authors.lastname: Yusuf
authors.forename: E S
authors.initials: ES
authors.lastname: Cantu
authors.forename: J C
authors.initials: JC
authors.lastname: Barredo
authors.forename: L B
authors.initials: LB
authors.lastname: Holt
authors.forename: M R
authors.initials: MR
authors.lastname: Abboud
mesh_terms: D000293:Adolescent; D000328:Adult; D002880:Chromosomes, Human, Pair 11; D002897:Chromosomes, Human, Pair 7; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics*; D008297:Male; D009006:Monosomy; D009190:Myelodysplastic Syndromes / Q000235:genetics*; D016609:Neoplasms, Second Primary / Q000235:genetics*; D014178:Translocation, Genetic