Therapy-related acute myeloid leukemia after single-agent treatment with fludarabine for chronic lymphocytic leukemia.
A 70-year-old man with B-cell chronic lymphocytic leukemia (CLL) received single-agent treatment with the purine analogue fludarabine, which led to complete remission. After 8 years, he presented with pancytopenia. Marrow examination showed acute myeloid leukemia (AML) with trilineage myelodysplasia (MDS). Cytogenetic analysis showed an unbalanced der(1;7)(p10;q10) that resulted effectively in deletion 7q; confirming the diagnosis of therapy-related AML (t-AML). No residual CLL was present. Together with previous reports of secondary cancers after fludarabine treatment and the association of monosomy 7/7q- with another purine analogue azathioprine, results suggest that t-AML might develop after fludarabine therapy.
Lam
Clarence C K
CC
Department of Pathology, University of Hong Kong, Hong Kong.
Ma
Edmond S K
ES
Kwong
Yok-Lam
YL
D000208:Acute Disease; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002897:Chromosomes, Human, Pair 7; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D007951:Leukemia, Myeloid / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology; D008297:Male; D009006:Monosomy; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine