A case of chronic myeloid leukemia with minor bcr-abl transcript following fluorouracil therapy for esophageal carcinoma

Abstract

We report here a very rare case of chronic myeloid leukemia (CML) with a minor bcr-abl transcript, which developed following long-term chemotherapy with fluorouracil for esophageal carcinoma. A 64-year-old male patient was diagnosed with CML. Four years earlier, he had suffered from esophageal carcinoma, which was treated by surgical resection followed by oral administration of fluorouracil (200 mg/day) for 4 years. Molecular analysis of his Philadelphia chromosome (Ph) using reverse-transcriptase polymerase chain reaction (RT-PCR) and subsequent sequencing revealed a minor bcr-abl transcript. The clinical course of this patient was aggressive with a short chronic phase of CML. This is the first reported case of secondary CML with a minor bcr-abl transcript.

Development of Chronic Myelocytic Leukemia after Chemotherapy for Malignant Fibrous Histiocytoma

“…To our knowledge, detailed information has been given on 20 patients with treatment-related CML following anti-tumor treatment [1, 3, 6, 7]. In these patients, the median interval from initial onset of disease to the onset of CML was 66 months (18–150 months) [7]. In this respect, the findings for our patient agree with those noted in previous reports.…”

“…Other reports have noted intervals of 60–72 months [4, 5]. To our knowledge, detailed information has been given on 20 patients with treatment-related CML following anti-tumor treatment [1, 3, 6, 7]. In these patients, the median interval from initial onset of disease to the onset of CML was 66 months (18–150 months) [7].…”

Philadelphia chromosome-positive acute lymphoblastic leukemia secondary to chemoradiotherapy for Ewing sarcoma. Report of two cases and concise review of the literature

“…Most of these patients have the expected p210 bcr-abl splice usually found in CML, but there is one report of a patient with p190 bcr-abl + CML that developed after treatment of esophageal cancer with fluorouracil [23]. One patient was reported with lymphoid blast crisis of CML that was p210 + at 7 years after chemoradiotherapy for NHL [24].…”

Chronic Myeloid Leukemia following Chemotherapy with 5'-deoxy-5-fluorouridine for Gastric Cancer

“…These cases including our case are summarized in Table 1 (11)(12)(13)(14)(15)(16) T a b l e 1 . T h e r a p y -r e l a t e d Ch r o n i c My e l o i d L e u k e mi a ( CML ) F o l l o wi n g F l u o r o p y r i mi d i n …”