J Korean Med Sci.  1999 Jun;14(3):327-329. 10.3346/jkms.1999.14.3.327.

Four cases of therapy-related leukemia

• Hur M
• Lee DS
• Shin HY
• Ahn HS
• Kim BK
• Cho HI

• KMID: 646314
• DOI: http://doi.org/10.3346/jkms.1999.14.3.327

Abstract

Combination chemotherapy and radiation therapy have contributed to the successful treatment of various cancer patients. But the development of second malignancies is an inevitable complication of long-term cytotoxic treatment. The most serious and frequent of such complications is acute myelogenous leukemia (AML). Therapy-related leukemia is generally fatal. Since the number of patients exposed to chemotherapy is increasing each year, the clinical significance of this entity cannot be underestimated. There have been many investigations of therapy-related leukemia, but in Korea published reports are rare. We describe four such cases, involving one older female with lung cancer and three children with acute lymphoblastic leukemia (ALL) and malignant lymphoma. Alkylating agents were used for chemotherapy, and in one case, topoisomerase II inhibitor. Irrespective of the causative agents, the latency periods were relatively short, and despite induction chemotherapy in two, all survived for only a few months. During the follow-up of patients treated for primary malignancies, the possibility of therapy-related leukemia should always be borne in mind.

Keyword

Neoplasms, second primary; Therapeutics; Leukemia

MeSH Terms

Adolescence
Aged
Antineoplastic Agents, Alkylating/therapeutic use*
Antineoplastic Agents, Alkylating/adverse effects
Carcinoma, Small Cell/radiotherapy
Carcinoma, Small Cell/drug therapy
Case Report
Child
DNA Topoisomerase (ATP-Hydrolysing)/antagonists & inhibitors
Fatal Outcome
Female
Human
Leukemia, Lymphocytic, Acute, L1/drug therapy
Leukemia, Monocytic, Acute/etiology
Leukemia, Myelocytic, Acute/etiology*
Leukemia, Myelomonocytic, Acute/etiology*
Lung Neoplasms/radiotherapy
Lung Neoplasms/drug therapy
Lymphoma, B-Cell/radiotherapy
Lymphoma, B-Cell/drug therapy
Male
Neoplasms, Second Primary/etiology*