title: AML transformation after autologous stem cell transplant for multiple myeloma.
abstract: A 59-year-old male patient was diagnosed as multiple myeloma in 2005 and received chemotherapy consisting of thalidomide, cyclophosphamide, and dexamethasone. The patient subsequently received high-dose melphalan followed by autologous stem cell transplantation and maintenance therapy with thalidomide. During the follow-up, the patient developed fever and cytopenias in 2012. The work up revealed 55% blasts in the marrow with myeloid phenotype leading to a diagnosis of acute myeloma leukaemia (AML). The karyotype was normal (46,XY) on conventional cytogenetics. The therapy was initiated, however, the patient expired within 1 month of diagnosis. The treatment related factors like alkylating agents are usually taken as the responsible agents for therapy-related AML, however, recent studies have proposed a multifactorial pathogenesis of leukaemic transformation in multiple myeloma.
authors.affiliation: Lab Oncology Unit, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Sanjeev Kumar
authors.initials: SK
authors.lastname: Gupta
authors.affiliation: Lab Oncology Unit, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Jagan
authors.initials: J
authors.lastname: Chandramohan
authors.affiliation: Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Lalit
authors.initials: L
authors.lastname: Kumar
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000473:pathology*; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome