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

Autor: Takeda, Reina, Yokoyama, Kazuaki, Kobayashi, Seiichiro, Kawamata, Toyotaka, Nakamura, Sousuke, Fukuyama, Tomofusa, Ito, Mika, Yusa, Nozomi, Shimizu, Eigo, Ohno, Nobuhiro, Yamaguchi, Rui, Imoto, Seiya, Miyano, Satoru, Uchimaru, Kaoru, Tojo, Arinobu
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Case Reports in Hematology.
ISSN: 2090-6560
DOI: 10.1155/2019/4532434
Popis: 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.
Databáze: OpenAIRE
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