Chronic Myelomonocytic Leukemia with t(1;3)(p3 6;q2 1 ) and a Synchronous Gastric Cancer

Patients with myelodysplastic syndrome (MDS) show a relatively high incidence of developing cancers. However, it is extremely rare that synchronous double cancers develop in an MDS patient. We report a case of MDS that progressed rapidly into erythroleukemia (M6 by French-American-British classification) complicated by gastric cancer and carcinoma of the papilla of Vater. A 66-year-old man was admitted because of pancytopenia with peripheral blasts. A diagnosis of MDS (with refractory anemia with excess of blasts in transformation [RAEB-T]) was made by bone marrow examination. Chromosome analysis revealed 46,XY. An early gastric cancer was also diagnosed by endoscopic examination. The peripheral blasts gradually proliferated and the disease progressed to M6. A chromosome abnormality 46,XY,del(1)(q42) was detected at the leukemic transformation. A CAG (low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor) regimen was started as a remission-induction therapy. However, obstructive jaundice developed and a marked dilatation of bile ducts was observed by abdominal computed tomography (CT). A carcinoma of the papilla of Vater was detected by endoscopy. As remission was achieved and the pancytopenia improved, the patient subsequently underwent a surgical jejuno-choledochostomy to manage the jaundice. However, the leukemia relapsed thereafter and additional chromosome abnormalities including der(5)t(5;10)(p15:q11) were observed.

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Myelodysplastic Syndrome Progresses Rapidly Into Erythroleukemia Associated With Synchronous Double Cancers of the Stomach and the Papilla of Vater

Takahashi

Kazama

Shimizu

et al. 2001

Int J Hematol

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Acute Myelogenous Leukemia Suddenly Developing Just After Surgery for Advanced Gastric Cancer: Report of a Case

et al. 2005

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We report a case of acute myelogenous leukemia (AML) developing just after surgery for advanced gastric cancer, before adjuvant chemotherapy was started. Immature white blood cells were recognized in the peripheral blood from postoperative day (POD) 1. The patient's clinical status and bone scintigraphy showed no evidence of bone metastasis. Acute myelogenous leukemia was diagnosed by an aspiration biopsy of the bone marrow. If the AML had developed later and had become remarkable during or after adjuvant chemotherapy, the differential diagnosis between de novo and therapy-related leukemia would have been very difficult. Most leukemias that develop during the course of chemotherapy or radiotherapy, or both, are indisputably considered to be therapy-related. Thus, we report the clinical course of this patient with reference to the related literature to warn surgeons of the possibility of this unusual manifestation.

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Chronic Myelomonocytic Leukemia with t(1;3)(p3 6;q2 1 ) and a Synchronous Gastric Cancer

Cited by 2 publications

References 16 publications

Myelodysplastic Syndrome Progresses Rapidly Into Erythroleukemia Associated With Synchronous Double Cancers of the Stomach and the Papilla of Vater

Myelodysplastic Syndrome Progresses Rapidly Into Erythroleukemia Associated With Synchronous Double Cancers of the Stomach and the Papilla of Vater

Acute Myelogenous Leukemia Suddenly Developing Just After Surgery for Advanced Gastric Cancer: Report of a Case

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