Acute myeloid leukemia and lung cancer occurring in a chronic lymphocytic leukemia patient treated with fludarabine and autologous peripheral blood stem-cell transplantation.
An increased incidence of different malignancies associated to chronic lymphocytic leukemia (CLL) has been reported. The association of CLL and acute leukemia is a rare event described in < 1% of CLL, the type of acute leukemia being either from the lymphoid or more often from the myeloid lineage. The coexistence of acute myeloid leukemia (AML) and CLL in the same patient has been occasionally reported. Most of these cases have been associated with the administration of chemotherapy or radiotherapy for CLL, suggesting that the former may be a secondary leukemia. On the other hand, CLL could precede, but could also be diagnosed at the same, or delayed time as AML, suggesting the presence of other leukemogenic factors. We describe the exceptional development of AML and lung cancer in a patient with previously diagnosed CLL in minimal residual disease status after fludarabine treatment followed by autologous peripheral blood stem-cell transplantation.
Meloni
G
G
Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Roma, Italy. meloni@bce.med.uniroma1.it
Proia
A
A
Guerrisi
V
V
Cordone
I
I
De Cuia
R
R
Fenu
S
S
Mauro
F R
FR
Pescarmona
E
E
Reato
G
G
Mandelli
F
F
D000208:Acute Disease; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D020022:Genetic Predisposition to Disease; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000628:therapy*; D007951:Leukemia, Myeloid / Q000209:etiology*; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D009378:Neoplasms, Multiple Primary; D016609:Neoplasms, Second Primary; D011994:Recombinant Proteins / Q000009:adverse effects; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D011994:Recombinant Proteins; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D014740:Vidarabine; C024352:fludarabine; D002330:Carmustine