A case of therapy-related acute myeloblastic leukemia with t(16;21)(q24;q22) after chemotherapy with DNA-topoisomerase II inhibitors, etoposide and mitoxantrone, and the alkylating agent, cyclophosphamide.
A 59-year-old female suffering from malignant lymphoma developed therapy-related acute myeloblastic leukemia (t-AML) after chemotherapy consisting of treatment with DNA-topoisomerase II inhibitors, etoposide and mitoxantrone, and an alkylating agent, cyclophosphamide. The cumulative dose of etoposide administration was 5500 mg; 1500 mg given intravenously and 4000 mg orally. One year later, she suddenly developed AML of FAB M2. Cytogenetic analysis of bone marrow cells revealed deletion of 7q and a rare translocation, t(16;21)(q24;q22). Southern blot analysis of bone marrow cells did not detect rearrangement of the AML1 gene, however, fluorescence in situ hybridization (FISH) analysis of bone marrow cells at interphase and metaphase revealed a translocational splitting between chromosome 21 involving AML1 gene and chromosome 16. These results suggest that the breakpoint is not located in the breakpoint cluster region for t(8;21). The patient was treated with chemotherapy and entered complete remission.
Takeda
K
K
Department of Medicine, Yamaguchi Prefecture Central Hospital, Hofu, Japan.
Shinohara
K
K
Kameda
N
N
Ariyoshi
K
K
D000477:Alkylating Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D015139:Blotting, Southern; D002885:Chromosomes, Human, Pair 16 / Q000235:genetics*; D002891:Chromosomes, Human, Pair 21 / Q000235:genetics*; D003360:Cosmids / Q000235:genetics; D003520:Cyclophosphamide / Q000008:administration & dosage; D015342:DNA Probes / Q000235:genetics; D004250:DNA Topoisomerases, Type II / Q000009:adverse effects / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D017353:Gene Deletion; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced / Q000209:etiology* / Q000235:genetics*; D007953:Leukemia, Radiation-Induced / Q000209:etiology; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D059005:Topoisomerase II Inhibitors; D014178:Translocation, Genetic / Q000235:genetics*
D000477:Alkylating Agents; D000970:Antineoplastic Agents; D015342:DNA Probes; D059005:Topoisomerase II Inhibitors; D005047:Etoposide; D003520:Cyclophosphamide; D008942:Mitoxantrone; D004250:DNA Topoisomerases, Type II; D011241:Prednisone