Oxaliplatin-related acute myelogenous leukemia.
A 56-year-old woman diagnosed with a poorly differentiated cecal adenocarcinoma with metastases to ovaries, omentum, and sigmoid colon went into remission after 12 cycles of infusional 5-fluorouracil, luecovorin, and oxaliplatin (FOLFOX-4 regimen). Thirteen months later, a pelvic recurrence was diagnosed, and the patient received nine cycles of FOLFOX-6 plus bevacizumab, resulting in a clinical complete response but the development of pancytopenia. Bone marrow biopsy was consistent with therapy-related acute myelogenous leukemia. Chromosome analysis showed structural rearrangements with partial deletions of the long arms of chromosomes 5, 7, 20, and 21, as well as trisomy of chromosome 8 and losses of chromosomes 3 and 11. Induction chemotherapy led to remission, but the patient died two months later from complications of colon cancer progression. It is likely that the leukemia was related to the oxaliplatin administration.
Department of Medicine, Kellogg Cancer Care Center, Evanston Northwestern Healthcare, Evanston, Illinois 60201, USA.
Benedito A
BA
Carneiro
Lynne
L
Kaminer
Mohammed
M
Eldibany
Chandrika
C
Sreekantaiah
Karen
K
Kaul
Gershon Y
GY
Locker
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D000068258:Bevacizumab; D002430:Cecal Neoplasms / Q000188:drug therapy / Q000473:pathology; D002872:Chromosome Deletion; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000235:genetics; D008875:Middle Aged; D009852:Omentum / Q000473:pathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000556:secondary; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary; D012811:Sigmoid Neoplasms / Q000188:drug therapy / Q000556:secondary; D014314:Trisomy
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil