Occurrence of T-cell lymphoma in a patient with acute myelogenous leukemia

Abstract

We describe a patient with AML with a monocytic component who developed a T-lymphoblastic lymphoma. Lymphoma was diagnosed 9 months following AML diagnosis. To our knowledge, this is the first report of phenotypically documented T-cell lymphoma following AML. The questions relating to the pathogenesis of the two malignancies are discussed.

The occurrence of T-cell malignancies in patients treated by chemotherapy for acute myeloid leukemia

“…Although the etiology of these malignancies remains elusive, the possible immunosuppressive or carcinogenic action of the chemotherapeutic drugs used may be crucial for the development of T-cell malignancies. The role of chemotherapy in the pathogenesis of T-cell lymphoma may seem doubtful in the case reported by Thomas et al [4] with the very short interval between the two malignancies. However, lymphomas may develop within an average of 7 months after bone marrow or renal transplantation and powerful immunosuppressive therapy with cyclosporine or CD3 antibodies [3,5].…”

“…In a recent issue of Annals of Hematology [4] a 42-yearold woman with acute myeloid leukemia (AML) M4 FAB subtype and a normal bone marrow karyotype was described. She achieved complete remission after two cycles of cytarabine-daunorubicin and cytarabinemitoxantrone.…”

“…Further cases are necessary to elucidate the possible association of secondary T-cell malignancies in AML cases and chromosome 6 abnormalities, chemotherapeutic drugs used (and their doses) leading to severe immunosuppression, or a possible viral infection leading to both types of hematological neoplasms, especially when they occur simultaneously or within a short period [2,4].…”

Mucosa-Associated Lymphoid Tissue Type Lymphoma of the Gallbladder Associated with Acute Myeloid Leukemia.

“…These disorders involve stem cells capable of multilineage differentiation. There are some reports of therapy-related AMLafter treatment of lymphoma, especially with alkylating agents (5), but the association of malignant lymphomawith AMLis extremely rare (6)(7)(8)(9). A few reports have investigated cell origins by using monoclonal antibody methods (9).…”

“…Wepresent a rare case of MALT type lymphoma arising from the gallbladder. Interestingly, the patient developed acute myeloid leukemia (AML, M2) within one month after the diagnosis of lymphoma.There have been some reports of therapy-related leukemia (5) after administration of anticancer drugs with carcinogenic effects, but the concurrent presentation of malignant lymphomawith AMLis extremely rare (6)(7)(8)(9) and the pathogenesis of this association is unclear. Webelieve this rarity suggests that the simultaneous development of both disorders in this case was a chance event.…”