Acute myeloid leukemia complicating multiple myeloma: a case successfully treated with etoposide, thioguanine, and cytarabine.
BACKGROUND
The association of acute leukemia and multiple myeloma (MM) has been usually described not only as a complication of chemotherapy but also in the absence of chemotherapy or together at the time of diagnosis. Such leukemias are typically acute myeloid leukemia (AML). The myelomonocytic subtype is particularly found.


METHODS
We report a case of a 68-year-old female who developed AML 2 years after the diagnosis of light chain (kappa) myeloma. She had been treated with oral melphalan and prednisone for MM. The patient was treated with an anthracycline-lacking therapy consisting of etoposide 120 mg/m2, thioguanine 100 mg/m2 orally twice daily on 1-5 days, and cytarabine 40 mg/m2 subcutaneously on day 1 (ETC) because of poor cardiac performance.


CONCLUSIONS
Following ETC therapy our particular patient has been in complete hematologic remission for 29 months. This therapy might be a safe alternative in secondary leukemia especially for elderly patients.
Erikci
Alev Akyol
AA
Department of Hematology, GATA Haydarpasa Training Hospital, Istanbul, Turkey. aleverikci@yahoo.com
Ozturk
Ahmet
A
Tekgunduz
Emre
E
Sayan
Ozkan
O
D000284:Administration, Oral; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012074:Remission Induction; D013866:Thioguanine / Q000008:administration & dosage / Q000627:therapeutic use*
D003561:Cytarabine; D005047:Etoposide; D013866:Thioguanine