Secondary acute myelogenous leukemia with MLL gene rearrangement following radioimmunotherapy (RAIT) for non-Hodgkin's lymphoma.
Targeted therapy with conjugated and unconjugated monoclonal antibodies for non-Hodgkin's lymphoma has revolutionized the approach to this disease. The efficacy and low toxicity of these agents have allowed introduction of this strategy in the early stages of therapy. Longer follow-up is needed before validating the safety of these agents. Since monoclonal antibodies are being given as front-line therapy, it is important to identify all potential adverse events. We report a case of secondary acute myelogenous leukemia (AML) with 11q23 cytogenetic abnormality and mixed lymphoid leukemia (MLL) gene expression in a patient treated with Y90 labeled anti-CD20 antibody (Zevalin). The patient was not exposed to topoisomerase II inhibitors. Our observations suggest a relationship between 11q23 leukemia and radioimmunotherapy (RAIT) and further studies are needed.
Nabhan
C
C
Division of Hematology/Oncology, Department of Medicine, Northwestern University Medical School and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA. c-nabhan@northwestern.edu
Peterson
L A
LA
Kent
S A
SA
Tallman
M S
MS
Dewald
G
G
Multani
P
P
Gordon
L I
LI
D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000276:immunology; D002880:Chromosomes, Human, Pair 11 / Q000528:radiation effects; D004268:DNA-Binding Proteins / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement / Q000528:radiation effects; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D018796:Immunoconjugates / Q000009:adverse effects / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000209:etiology / Q000235:genetics*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000532:radiotherapy*; D051788:Myeloid-Lymphoid Leukemia Protein; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000235:genetics*; D011519:Proto-Oncogenes; D016499:Radioimmunotherapy / Q000009:adverse effects*; D014157:Transcription Factors; D015021:Yttrium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use
D018951:Antigens, CD20; D004268:DNA-Binding Proteins; D018796:Immunoconjugates; C497422:KMT2A protein, human; D014157:Transcription Factors; D015021:Yttrium Radioisotopes; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase