An Unusually Short Latent Period of Therapy-Related Myeloid Neoplasm Harboring a Rare MLL-EP300 Rearrangement: Case Report and Literature Review.
Reina TakedaKazuaki YokoyamaSeiichiro KobayashiToyotaka KawamataSousuke NakamuraTomofusa FukuyamaMika ItoNozomi YusaEigo ShimizuNobuhiro OhnoRui YamaguchiSeiya ImotoSatoru MiyanoKaoru UchimaruArinobu TojoPublished in: Case reports in hematology (2019)
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.
Keyphrases
- bone marrow
- acute myeloid leukemia
- room temperature
- radiation therapy
- newly diagnosed
- ejection fraction
- transition metal
- metal organic framework
- infectious diseases
- locally advanced
- prognostic factors
- mesenchymal stem cells
- case report
- cell therapy
- risk assessment
- liver failure
- gene expression
- sars cov
- intensive care unit
- single cell
- diffuse large b cell lymphoma
- dna methylation
- patient reported
- drug induced
- young adults
- smoking cessation
- aortic dissection