title: [Therapy-related chronic myelogenous leukemia following RFM therapy in a patient with follicular lymphoma].
abstract: Therapy-related myelodysplastic syndrome and acute myelogenous leukemia are increasingly being recognized as treatment complications in patients receiving chemotherapy or radiotherapy for previous neoplasms. However, therapy-related chronic myelogenous leukemia is relatively rare. A 61-year-old woman with a history of radiation therapy for breast cancer had previously, in 2007, received 4 courses of chemotherapy (RFM: rituximab, fludarabine, and mitoxantrone) for follicular lymphoma. In 2010, she was diagnosed with chronic-phase chronic myelogenous leukemia (CML) with Philadelphia chromosome but no other cytogenetic anomalies. Although a complete cytogenetic response (CCyR) was achieved with imatinib therapy, she developed leukocytosis with lymphoblasts and lymphoid crisis was diagnosed in January 2013. G-banded karyotyping showed 45, XX, -7, t, (9;22)(q33;q11.2). Unrelated bone marrow stem cell transplantation was performed after she had achieved a CCyR with dasatinib therapy. Polymerase chain reaction detected no major bcr/abl transcript in her bone marrow 42 days after transplantation. The majority of secondary leukemias resulting from the use of cytotoxic drugs can be divided into two well-defined groups depending on whether the patient has received alkylating agents or topoisomerase II inhibitors. However, concerns regarding the leukemogenic potential of fludarabine-based chemotherapy are growing. The potential risk of therapy-related leukemias including CML needs to be considered following fludarabine-based chemotherapy.
authors.affiliation: Nagano Red Cross Hospital.
authors.forename: Mio
authors.initials: M
authors.lastname: Shibazaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sumi
authors.forename: Wataru
authors.initials: W
authors.lastname: Takeda
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kirihara
authors.forename: Taro
authors.initials: T
authors.lastname: Kurihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sato
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Ueki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hiroshima
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ueno
authors.forename: Naoaki
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000139:chemically induced*; D008224:Lymphoma, Follicular / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D000069283:Rituximab; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008942:Mitoxantrone; D014740:Vidarabine; C024352:fludarabine