Therapy-related myelodysplastic syndrome in a case of cutaneous adult T-cell lymphoma.
We report a case of therapy-related myelodysplastic syndrome (t-MDS) in adult T-cell lymphoma. A 69-year-old man suffered from cutaneous adult T-cell lymphoma, which was treated with radiation to the skin and combination chemotherapy of CHOP-V-MMV and VEPA-B. After 14 months of these therapies, anemia and thrombocytopenia appeared, and bone marrow aspiration smears showed immature myeloblasts, dysplastic erythroblasts, and micromegakaryocytes. Therapy-related MDS of refractory anemia with an excess of blasts was diagnosed. Cytogenetic study of the bone marrow cells showed 5q- and additional abnormalities. Rearrangement of the MLL gene was observed in the bone marrow cells. Mutations of N-ras codons at 12,13, and 61, p53 tumor suppressor gene, and monoclonal integration of human T-lymphotrophic virus -1 provirus DNA were not observed in the bone marrow cells. The patient died of pneumonia 21 months after diagnosis of cutaneous adult T-cell lymphoma.
Fukuda
Naofumi
N
Department of Medicine, Yamaguchi Prefecture Central Hospital, Hofu, Japan.
Shinohara
Kenji
K
Ota
Ituro
I
Muraki
Kazuhiko
K
Shimohakamada
Yoko
Y
D000208:Acute Disease; D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000209:etiology* / Q000235:genetics / Q000821:virology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D015490:HTLV-I Infections / Q000150:complications; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D007564:Japan; D007951:Leukemia, Myeloid / Q000150:complications; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications; D016410:Lymphoma, T-Cell, Cutaneous / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy / Q000821:virology; D008297:Male; D009607:Nitrosourea Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011533:Proviruses / Q000302:isolation & purification; D011878:Radiotherapy / Q000009:adverse effects*; D012074:Remission Induction; D014178:Translocation, Genetic; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D009607:Nitrosourea Compounds; D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone