Acute promyelocytic leukemia after mitoxantrone therapy for multiple sclerosis.
Mitoxantrone is a DNA-topoisomerase 2 inhibitor used as a single agent for treatment of relapsing-remitting or progressive multiple sclerosis (MS). We present here two patients treated with mitoxantrone for MS who subsequently developed acute promyelocytic leukemia (APL). These constitute, to our knowledge, the eighth and ninth reports of APL in patients treated with mitoxantrone for MS. Topoisomerase 2 inhibitors are associated with therapy-related acute myeloid leukemia (t-AML) with 11q23 abnormalities, but therapy-related APL (t-APL) is less common, and documentation of nine cases of t-APL after mitoxantrone therapy for MS suggests a specific association.
Ramkumar
Bhuvaneswari
B
Department of Internal Medicine, Rochester General Hospital, Rochester, NY 14621, USA.
Chadha
Manpreet K
MK
Barcos
Maurice
M
Sait
Sheila N J
SN
Heyman
Meyer R
MR
Baer
Maria R
MR
D000970:Antineoplastic Agents / Q000009:adverse effects*; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D012074:Remission Induction; D014178:Translocation, Genetic
D000970:Antineoplastic Agents; D008942:Mitoxantrone