title: Three patients with multiple myeloma developing secondary lymphoblastic leukemia: case reports and review of the literature.
abstract: BACKGROUND
  Secondary lymphoblastic leukemia has been rarely reported in patients with multiple myeloma.
  
  
  METHODS
  We report 3 cases of secondary lymphoblastic leukemia in multiple myeloma patients. They shared a similar phenotype of myeloma cells and secondary lymphoblasts. The chemotherapy treatments in the 3 patients were complex due to various factors.
  
  
  CONCLUSIONS
  Multiple immune defects caused by exposure to a variety of agents can play an important role in the development of secondary lymphoblastic leukemia. Microscopic morphology and flow cytometry are important means to detect secondary malignancies in multiple myeloma. Further clinical, experimental and genetic studies of secondary malignancies in multiple myeloma will be necessary in the future.
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Li
authors.initials: L
authors.lastname: Junxun
authors.affiliation: Department of Hematology, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Liu
authors.initials: L
authors.lastname: Junru
authors.affiliation: Department of Hematology, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Chen
authors.initials: C
authors.lastname: Meilan
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Liang
authors.initials: L
authors.lastname: Chujia
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Chen
authors.initials: C
authors.lastname: Shaoqian
authors.affiliation: Department of Pediatrics, First Hospital of Baiyun District, Guangzhou - China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Jieyu
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhuangjian
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Ouyang
authors.initials: O
authors.lastname: Juan
authors.affiliation: Department of Laboratory Science, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Jing
authors.affiliation: Department of Hematology, First Affiliated Hospital of Sun Yatsen University, Guangzhou - China.
authors.forename: Li
authors.initials: L
authors.lastname: Juan
mesh_terms: D000130:Achondroplasia; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000209:etiology; D000072078:Positron Emission Tomography Computed Tomography; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome