Therapy‐related chronic myelogenous leukaemia following autologous stem cell transplantation for Ewing's sarcoma

Abstract

Summary.A 17-year-old Japanese woman with Ewing's sarcoma was initially treated with conventional chemotherapy and local irradiation, and then with high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation. Four years later she was diagnosed with chronic myelogenous leukaemia (CML). The BCR/ABL fusion gene was detected in both peripheral blood and bone marrow cells by reverse transcription-polymerase chain reaction, but not in the harvest product of peripheral blood stem cells which were infused at the time of transplantation. This case adds to the accumulating evidence of therapy-related CML developing after high-dose chemotherapy and autologous stem cell transplantation.

Chronic myeloid leukemia as a secondary malignancy after ALK-positive anaplastic large cell lymphoma

“…The only documented case of CML occurring as a secondary potentially therapy-related cancer is that of a 17-year-old patient who developed CML 4 years after chemotherapy for Ewing sarcoma [8].…”

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

“…One patient was reported with lymphoid blast crisis of CML that was p210 + at 7 years after chemoradiotherapy for NHL [24]. One 17-year-old patient was reported with p210 + t-CML after completing chemoradiotherapy for ES, followed by an autologous PB HCT [25]. Moss et al reported one case of t-CML in a patient treated for a Wilms tumor [26].…”

Chronic Myelogenous Leukemia That Occurred Two Years after the Diagnosis of Adult Still's Disease

“…Only rarely have cases been reported in which treatment-related CML developed after high-dose chemotherapy, radiation and autologous peripheral blood stem cell transplantation (16). Vincristine, adriamycin, cyclophosphamide, actinomycin-D, carboplastin, etoposide, ifosfamide and local irradiation for the treatment of Ewing's sarcoma developed secondary CML (16). However, these secondary CML patients were often negative for the BCR/ ABL gene, and there are no reports of the use of only immunosuppressive drugs, including cyclosporine and cyclophosphamide, causing secondary CML.…”

“…In the present case, the BCR/ ABR fusion gene characteristic of CML developed after 10 months of treatment with cyclosporine and before any morphological abnormality appeared, suggesting that hematopoietic system malignancy might develop soon after cyclosporine treatment. Only rarely have cases been reported in which treatment-related CML developed after high-dose chemotherapy, radiation and autologous peripheral blood stem cell transplantation (16). Vincristine, adriamycin, cyclophosphamide, actinomycin-D, carboplastin, etoposide, ifosfamide and local irradiation for the treatment of Ewing's sarcoma developed secondary CML (16).…”