An Unusually Short Latent Period of Therapy-Related Myeloid Neoplasm Harboring a Rare MLL-EP300 Rearrangement: Case Report and Literature Review

Reina Takeda; Kazuaki Yokoyama; Seiichiro Kobayashi; Toyotaka Kawamata; Sousuke Nakamura; Tomofusa Fukuyama; Mika Ito; Nozomi Yusa; Eigo Shimizu; Nobuhiro Ohno; Rui Yamaguchi; Seiya Imoto; Satoru Miyano; Kaoru Uchimaru; Arinobu Tojo

doi:10.1155/2019/4532434

An Unusually Short Latent Period of Therapy-Related Myeloid Neoplasm Harboring a Rare MLL-EP300 Rearrangement: Case Report and Literature Review

Case Rep Hematol. 2019 Oct 2:2019:4532434. doi: 10.1155/2019/4532434. eCollection 2019.

Authors

Reina Takeda^{1

2}, Kazuaki Yokoyama¹, Seiichiro Kobayashi³, Toyotaka Kawamata^{1

3}, Sousuke Nakamura³, Tomofusa Fukuyama^{1

2}, Mika Ito³, Nozomi Yusa⁴, Eigo Shimizu⁵, Nobuhiro Ohno^{1

3}, Rui Yamaguchi⁵, Seiya Imoto⁶, Satoru Miyano^{5

6}, Kaoru Uchimaru^{1

7}, Arinobu Tojo^{1

3}

Affiliations

¹ Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
² Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
³ Division of Molecular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
⁴ Department of Applied Genomics, Research Hospital, Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
⁵ Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
⁶ Division of Health Medical Data Science, Health Intelligence Center, Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
⁷ Laboratory of Tumor Cell Biology, Department of Computational Biology and Medical Science, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 108-8639, Japan.

Abstract

Therapy-related myeloid neoplasm (t-MN) is a late and lethal complication induced by chemotherapy and/or radiation therapy. Hematological malignancy is one of the most common primary diseases in patients with t-MN. However, the occurrence of t-MN in adult T-cell leukemia/lymphoma (ATL) patients is rarely reported, possibly due to the dismal prognosis of ATL per se. Here, we report a 62-year-old female who developed t-MN only three months after the completion of conventional chemotherapy and anti-CCR4 antibody for ATL acute type. The patient presented with persistent fever and monocytosis without any evidence of infectious diseases. Bone marrow examinations revealed chronic myelomonocytic leukemia-like disease with a chromosomal translocation of t(11;22)(q23;q13) as a solo cytogenetic abnormality, resulting in the diagnosis of t-MN. Next-generation sequencing analysis identified a rare chimeric transcript, MLL-EP300, without any additional somatic mutations. Although the patient underwent allogenic hematopoietic stem cell transplantation, she died of viral encephalomyelitis at 7 months after diagnosis of t-MN. Since recent therapeutic advances have extended the survival of patients with ATL, further evaluation of the long-term risks of developing t-MN in these patients is warranted.

Publication types

Case Reports