Therapy-related Myelodysplastic Syndrome with Trisomy 1q due to der(1;7) and Megakaryoblastic Proliferation Developing during Complete Remission of Therapy-related Acute Myeloid Leukemia with t(8;21)

Abstract

Therapy-related acute myeloid leukemia (t-AML) with t(8;21) and therapy-related myelodysplastic syndrome (t-MDS) with trisomy 1q due to der(1;7) developed in the same patient with T-cell lymphoma at intervals of six years. After the development of t-MDS with trisomy 1q, during complete remission of t-AML, the number of megakaryoblasts increased to maximally 74% of leukocytes in the blood. This is a very rare case of two separate therapy-related myeloid malignancies (early t-AML and late t-MDS) and is also a notable case of t-MDS with trisomy 1q due to der(1;7) accompanied by megakaryoblastic proliferation.

Role of chromosome 1 pericentric heterochromatin (1q) in pathogenesis of myelodysplastic syndromes: Report of 2 new cases

“…Several different rearrangements of chromosome 1 have been identified in these malignancies, but trisomy or duplication of the long arm is the most frequent abnormality (Sakai et al, 2004;Morerio et al, 2006). Furthermore, chromosome 1 pericentric heterochromatin rearrangements appear to be common in hematologic malignancies such as follicular lymphoma, diffuse large B cell lymphoma, Burkitt's lymphoma, multiple myeloma, and also in myelodysplastic syndromes (MDS).…”

Therapy-Related Acute Megakaryoblastic Leukemia in a Lung Cancer Patient

“…Acute megakaryoblastic leukemia (AMKL) (M7) is the least common of the t-AML French-American-British (FAB) subtypes, and only two such cases have been reported to date [3, 4], neither of which was in Korea. AMKL accounts for about 7-10% of childhood AML cases (frequently associated with Down syndrome), but only about 1% of adult AML cases [5].…”

“…This case therefore showed clinical features typical of the former subset of t-AML/t-MDS. The two previously reported t-AMKL cases also involved dysplastic features, unbalanced chromosomal rearrangements, and a history of alkylating agent or radiation therapy (Table 1) [3, 4]. …”

Double Therapy-related Leukemia: Coincidental Occurrence or Susceptibility for Leukemia?

“…In this issue, Sakai et al report an extraordinarily suggestive case of therapy-related leukemia, who developed two different types of t-AML/MDS with an interval of several years (6). The patient had at first peripheral T-cell lymphoma, and received chemotherapy with several cytotoxic chemicals including both alkylating agents and topoisomerase II inhibitors, followed by whole brain irradiation to the relapsed lesion.…”