title: A rare case of acute lymphoblastic leukemia in a patient with light chain (AL) amyloidosis treated with lenalidomide.
abstract: Lenalidomide belongs to a novel class of drugs called Immunomodulators which are now being used for the treatment of plasma cell dyscrasias with variable degrees of efficacy and toxicity. Though Second Primary Malignancies (SPM) have been a concern with its use, the benefits of the treatment outweigh the risks. The leukemogenic risk seems to be potentiated especially when combined with alkylating agents and the SPMs documented are predominantly myeloblastic. To date there are no reported cases of new lymphocytic leukemias in AL amyloidosis, regardless of whether undergone treatment or not. We present a case of AL amylodosis who was treated with lenalidomide and subsequently developed acute lymphoblastic leukemia.
authors: Department of Internal Medicine, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
authors: Ranjit
authors: R
authors: Nair
authors: Department of Pathology, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
authors: Shereen
authors: S
authors: Gheith
authors: Department of Hematology/Oncology, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
authors: Dan
authors: D
authors: Popescu
authors: Department of Hematology/Oncology, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
authors: Nicole M
authors: NM
authors: Agostino
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001718:Birefringence; D001856:Bone Marrow Examination; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis*; D007155:Immunologic Factors / Q000009:adverse effects*; D000077269:Lenalidomide; D008859:Microscopy, Polarization; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D012008:Recurrence; D012307:Risk Factors; D016879:Salvage Therapy; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: AL amyloidosis; Second primary malignancy; acute lymphoblastic leukemia; lenalidomide