Korean J Lab Med.  2007 Aug;27(4):244-247. 10.3343/kjlm.2007.27.4.244.

A Case of Therapy-Related Acute Monocytic Leukemia following Low-dose of Etoposide Treatment for Hemophagocytic Lymphohistiocytosis

• Seo YI
• Park R
• Choi TY
• Shin JW
• Won JH
• Park HS
• Lee NS
• Cho D

• KMID: 1781491
• DOI: http://doi.org/10.3343/kjlm.2007.27.4.244

Abstract

We report a case of therapy-related acute myeloid leukemia after low-dosed topoisomerase II inhibitor (etoposide) treatment for hemophagocytic lymphohistiocytosis (HLH). A 62-yr-old female patient had previously been treated with a HLH-94 protocol containing a low-dose of etoposide (total dose of 300 mg/m2). Thirty-one months later, the patient was admitted to the hematology department with general weakness and upper respiratory infection symptoms. Peripheral blood smear and bone marrow study revealed acute monocytic leukemia. There was no evidence of myelodysplastic syndrome, and a cytogenetic study showed no chromosomal abnormalities.

Keyword

Etoposide; Hemophagocytic lymphohistiocytosis; Therapy-related acute leukemia

MeSH Terms

Bone Marrow/pathology
Etoposide/administration & dosage/*adverse effects
Female
Humans
Leukemia, Monocytic, Acute/*chemically induced/*diagnosis/therapy
Lymphohistiocytosis, Hemophagocytic/complications/*drug therapy
Middle Aged

Figure

• 

  Fig. 1. Initial bone marrow aspirate smear. Histiocytes were increased in number and counted up to 15% of all nucleated cells. Hemophagocytosis was predominantly observed (Wright-Giemsa stain, ×1,000).

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  Fig. 2. Bone marrow aspirate smear 31 months following etoposide treatment. Promonocytes and monoblasts accounted for 89% of all nucleated cells (Wright-Giemsa stain, ×1,000).

Reference

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