Therapy-related acute myeloid leukemia after single-agent treatment with fludarabine for chronic lymphocytic leukemia

Am J Hematol. 2005 Aug;79(4):288-90. doi: 10.1002/ajh.20340.

Abstract

A 70-year-old man with B-cell chronic lymphocytic leukemia (CLL) received single-agent treatment with the purine analogue fludarabine, which led to complete remission. After 8 years, he presented with pancytopenia. Marrow examination showed acute myeloid leukemia (AML) with trilineage myelodysplasia (MDS). Cytogenetic analysis showed an unbalanced der(1;7)(p10;q10) that resulted effectively in deletion 7q; confirming the diagnosis of therapy-related AML (t-AML). No residual CLL was present. Together with previous reports of secondary cancers after fludarabine treatment and the association of monosomy 7/7q- with another purine analogue azathioprine, results suggest that t-AML might develop after fludarabine therapy.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bone Marrow / pathology
  • Chromosomes, Human, Pair 7
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Myeloid / chemically induced*
  • Leukemia, Myeloid / genetics
  • Leukemia, Myeloid / pathology
  • Male
  • Monosomy
  • Neoplasms, Second Primary / chemically induced*
  • Neoplasms, Second Primary / genetics
  • Neoplasms, Second Primary / pathology
  • Vidarabine / administration & dosage
  • Vidarabine / adverse effects
  • Vidarabine / analogs & derivatives*
  • Vidarabine / therapeutic use

Substances

  • Antineoplastic Agents
  • Vidarabine
  • fludarabine