Simultaneous occurrence of advanced neuroblastoma and acute myeloid leukemia.
The authors report the case of a 4-year-old boy with a diagnosis of stage IV neuroblastoma (NB), who had been treated with 6 cycles of cyclophosphamide, doxorubicin, cisplatin, and etoposide for 12 months. The patient reached partial remission and presented a diagnosis of acute myelomonocytic leukemia (M4 AML), confirmed by immunophenotyping. After 2 months of therapy for leukemia, the child died with both malignancies in activity. A necropsy histologically confirmed the simultaneity of the two diseases. The authors review the possibilities of this association. The review leads to the conclusion that AML can occur as a secondary malignancy after the onset of the neuroblastoma, or be suggested by a misdiagnosis. The simultaneous occurrence of both as described here is not, however, found in the literature, to the best of the authors' knowledge.
Hematology/Oncology Division, Children's Institute of the Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil.
T M
TM
Santos-Machado
M C
MC
Zerbini
L M
LM
Cristofani
P M
PM
Azevedo
M T
MT
Almeida
P T
PT
Maluf
V
V
Odone-Filho
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000633:toxicity; D001853:Bone Marrow / Q000473:pathology; D002675:Child, Preschool; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D015479:Leukemia, Myelomonocytic, Acute / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D009447:Neuroblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D009503:Neutropenia / Q000209:etiology
D018906:Antineoplastic Agents, Alkylating