Abstract
Therapy-related acute leukemia showing mixed phenotype is extremely rare. We report a 49-year-old woman who presented with palpable masses in her neck and back. She had received systemic chemotherapy (adriamycin and cisplatin) and radiotherapy for endometrial adenocarcinoma 7 years before. Her peripheral blood and bone marrow showed increased blasts, which coexpressed myeloid (CD13, CD33, and myeloperoxidase) and B-lymphoid antigens (CD19 and CD79a). Cytogenetic analysis showed a karyotype of 46,XX,dup(1)(q21q32),add(5)(q33),t(9;22)(q34;q11.2)[12]/47,idem,+der(22)t(9;22)[8], and BCR/ABL1 rearrangement was detected. Leukemic infiltration was also confirmed in her back mass. After induction chemotherapy with idarubicin, cytarabine, and imatinib, she achieved complete remission. Only 2 cases of therapy-related acute leukemia with mixed phenotype have been reported so far: one with hyperploidy and the other with t(1;21)(p36;q22). To the best of our knowledge, this is the first case of therapy-related acute leukemia with mixed phenotype and t(9;22) as well as extramedullary leukemic infiltrations.
Copyright © 2012 Elsevier Inc. All rights reserved.
MeSH terms
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Adenocarcinoma / drug therapy
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Adenocarcinoma / radiotherapy
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Back
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Benzamides
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Bone Marrow / pathology
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Chromosomes, Human, Pair 22 / genetics*
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Chromosomes, Human, Pair 9 / genetics*
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Cytarabine / administration & dosage
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Endometrial Neoplasms / drug therapy
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Endometrial Neoplasms / radiotherapy
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Female
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Gene Rearrangement
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Genes, abl / genetics
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Humans
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Idarubicin / administration & dosage
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Imatinib Mesylate
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Immunophenotyping
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Induction Chemotherapy
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Karyotyping
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Leukemia, Myeloid, Acute / chemically induced
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Leukemia, Myeloid, Acute / diagnosis
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Leukemia, Myeloid, Acute / genetics*
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Leukemia, Myeloid, Acute / therapy
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Leukemic Infiltration / chemically induced
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Leukemic Infiltration / diagnosis
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Leukemic Infiltration / genetics
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Leukemic Infiltration / therapy
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Middle Aged
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Neoplasms, Second Primary / chemically induced
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Neoplasms, Second Primary / diagnosis
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Neoplasms, Second Primary / genetics*
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Neoplasms, Second Primary / therapy
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Piperazines / administration & dosage
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Pyrimidines / administration & dosage
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Remission Induction
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Soft Tissue Neoplasms / chemically induced
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Soft Tissue Neoplasms / diagnosis
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Soft Tissue Neoplasms / genetics
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Soft Tissue Neoplasms / therapy
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Submandibular Gland Neoplasms / chemically induced
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Submandibular Gland Neoplasms / diagnosis
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Submandibular Gland Neoplasms / genetics
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Submandibular Gland Neoplasms / therapy
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Translocation, Genetic
Substances
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Benzamides
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Piperazines
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Pyrimidines
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Cytarabine
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Imatinib Mesylate
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Idarubicin