[Therapy-related myelodysplastic syndrome as a late adverse event of definitive chemoradiotherapy for esophageal and oropharyngeal cancer].
The risks of myelodysplastic syndrome (MDS) and acute leukemia are increased in patients previously treated for other malignancies. Therapy-related MDS (t-MDS) occurs after exposure to certain cytotoxic agents or radiation used for cancer treatment. We report a case of t-MDS following curative chemoradiotherapy (CRT) for esophageal and oropharyngeal cancer. An 80-year-old male diagnosed with double cancers of the esophagus and oropharynx underwent definitive CRT and achieved a complete response. Six years later, he became anemic, and bone marrow examination showed 3.4% blast cells with fine chromatin structures and basophilic cytoplasm. Cytogenetic analysis indicated a complex karyotype that included chromosome 5 and 7 abnormalities. These findings were consistent with t-MDS. Subsequently, he developed acute myeloid leukemia and died 8 months later. This case indicates that long-term surveillance is needed to closely monitor the risk of t-MDS in patients treated with CRT.
Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine.
Yusuke
Y
Kamihara
Yasushi
Y
Sato
Kohichi
K
Takada
Yutaka
Y
Okagawa
Satoshi
S
Iyama
Tsutomu
T
Sato
Koji
K
Miyanishi
Rishu
R
Takimoto
Masayoshi
M
Kobune
Junji
J
Kato
D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D009959:Oropharyngeal Neoplasms / Q000628:therapy*