Occurrence of myelodysplastic syndrome during paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer: Case report

Abstract

Platinum and taxane have significant activity as key drugs in current treatment of advanced ovarian cancer. While myelodysplastic syndrome (MDS) and acute leukemia are well-known secondary disease after administration of chemotherapy, particularly with alkylating agents, they have only rarely been reported in the context of ovarian cancer treatment. In this case report a 59-year-old Japanese developed a MSD during ongoing second induction chemotherapy with carboplatin and paclitaxel for recurrent ovarian cancer. Her second induction began 9 months after completion of her first course of chemotherapy. Cytogenetic analyses showed typical chromosomal aberration. Although the finding of pancytopenia is also seen during chemotherapy without MSD/acute leukemia, bone marrow aspiration and biopsy should be considered to confirm the clinical suspicion of the lifethreatening disease when encountered persistent pancytopenia following carboplatin-and paclitaxel-based chemotherapy in an ovarian cancer patient.

Secondary Hodgkin Lymphoma and Myelodysplastic Syndrome (MDS) After Paclitaxel-Carboplatin Treatment in a Patient with Small Cell Lung Cancer

“…In a review including 28 cases of the secondary diseases, the median latency between the start of therapy and the diagnosis of therapy-related MDS/AML was 2.5 years [15,16]. Our patient with SCLC developed Castelman disease three years after combined chemotherapy and radiotherapy.…”

“…This hypothesis is supported also by the appearance of the Castelman disease previously in the patient. There have been described therapy-related MDS/AML following cytotoxic chemotherapy of malignant tumors with classic alkylating agents, including nitrosoureas or procarbazin, radiation therapy alone, or combined chemotherapy and radiotherapy [14,15]. The risk is higher in elderly patients, and there are no known factors other than age and duration of therapy to predict which patients might be at higher risk of the secondary diseases.…”