Therapy-related myelodysplastic syndrome as a late adverse event of definitive chemoradiotherapy for esophageal and oropharyngeal cancer

  • KAMIHARA Yusuke
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • SATO Yasushi
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • TAKADA Kohichi
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • OKAGAWA Yutaka
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • IYAMA Satoshi
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • SATO Tsutomu
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • MIYANISHI Koji
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • TAKIMOTO Rishu
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • KOBUNE Masayoshi
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
  • KATO Junji
    Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine

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Other Title
  • 食道癌および中咽頭癌に対する根治的化学放射線併用療法の晩期有害事象と考えられたtherapy-related myelodysplastic syndromeの1例

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The risks of myelodysplastic syndrome (MDS) and acute leukemia are increased in patients previously treated for other malignancies. Therapy-related MDS (t-MDS) occurs after exposure to certain cytotoxic agents or radiation used for cancer treatment. We report a case of t-MDS following curative chemoradiotherapy (CRT) for esophageal and oropharyngeal cancer. An 80-year-old male diagnosed with double cancers of the esophagus and oropharynx underwent definitive CRT and achieved a complete response. Six years later, he became anemic, and bone marrow examination showed 3.4% blast cells with fine chromatin structures and basophilic cytoplasm. Cytogenetic analysis indicated a complex karyotype that included chromosome 5 and 7 abnormalities. These findings were consistent with t-MDS. Subsequently, he developed acute myeloid leukemia and died 8 months later. This case indicates that long-term surveillance is needed to closely monitor the risk of t-MDS in patients treated with CRT.

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