Development of Acute Monocytic Leukemia in a Patient after Chemotherapy for non-Hodgkin's Lymphoma

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  • Sugita Karina
    Department of Gastroenterology and Hepatology, Nihon University School of Medicine
  • Hatta Yoshihiro
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Miura Katsuhiro
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Kurita Daisuke
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Kobayashi Yujin
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Tanaka Toshitake
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Ishizuka Hikari
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Takei Kazuhiro
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Kobayashi Sumiko
    Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Aizawa Shin
    Department of Functional Morphology, Nihon University School of Medicine
  • Sugitani Masahiko
    Department of Pathology, Nihon University School of Medicine
  • Takeuchi Jin
    Department of Hematology and Rheumatology, Nihon University School of Medicine

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Other Title
  • 非ホジキンリンパ腫治療後に急性単球性白血病を合併した１例
  • 症例報告 非ホジキンリンパ腫治療後に急性単球性白血病を合併した1例
  • ショウレイ ホウコク ヒホジキンリンパ シュ チリョウ ゴ ニ キュウセイタンキュウセイ ハッケツビョウ オ ガッペイ シタ 1レイ

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Abstract

A 58-year old female suffering from cough, sputa, and dyspnea was referred to our hospital in June 1999. She was diagnosed with small cell lung cancer by lung biopsy. Serum LDH and NSE were increased. She achieved complete remission with chemotherapy (CDDP+Etoposide and CPA+DXR+VCR). In February 2000, acute monocytic leukemia (FAB classification M5b) with abnormal karyotype, t (8;16), developed. After induction therapy with IDR and Ara-C, partial remission was achieved. She discontinued follow-up at our hospital as of April 2003. In 2005, diffuse large B cell lymphoma (DLBCL) was identified in her right breast. Re-examination of the lung biopsy specimen obtained in 1999 revealed positivity for CD 20, suggesting B cell lymphoma. Despite the use of strong chemotherapeutics against DLBCL, her condition deteriorated and she died in September 2007. We suspect that the case was probably therapy-related leukemia, although concomitant occurrence of de novo leukemia in an NHL patient could not be refuted. We discuss the differences between therapy-related and de novo leukemia in the present case and review the literature.

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