At the age of 28, a 33-year-old male was diagnosed with malignant fibrous histiocytoma (MFH) with a primary lesion in the right maxillary sinus. Although arterial infusion chemotherapy (pirarubicin hydrochloride and carboplatin) was given, no tumor shrinkage was observed, and surgery was therefore performed to remove the tumor. Thereafter, the patient received autologous peripheral blood stem cell transplantation with high-dose chemotherapy (combination of ifosphamide, carboplatin and etoposide) as pretreatment. An increase in the peripheral leukocyte count was noted 56 months after the diagnosis of MFH was made. Cytogenetic study showed translocation (9;22)(q34;q11). Chronic myelocytic leukemia (CML) was therefore diagnosed. MFH was in a state of complete remission. The clinical course of this patient strongly suggests that this was a case of treatment-related CML that developed after chemotherapy for MFH. Treatment-related malignant blood diseases are known to include acute myelocytic leukemia and myelodysplastic syndrome, but reports of treatment-related CML are rare, although there have been some cases of treatment-related CML occurring several years after pretreatment.

Keywords:
Chemotherapy, Chronic myelocytic leukemia, Histiocytoma, malignant fibrous, Treatment-related malignancy
1.
Hsiao HH, Liu TC, Chang CS, Sue YC, Chen TP, Lin SF: Secondary chronic myelogenous leukemia after autologous peripheral blood stem cell transplantation for lymphoma. Int J Hematol 2001;73:126–128.
2.
Sharon WW, John RG: Malignant Fibrohistiocytic Tumors: Soft Tissue Tumors. St. Louis, Mosby, 2001, pp 535–570.
3.
Waller CF, Fetscher S, Lange W: Treatment-related chronic myelogenous leukemia. Ann Hematol 1999;78:341–354.
4.
Kamada N, Uchino H: Chronologic sequence in appearance of clinical and laboratory findings characteristic of chronic myelocytic leukemia. Blood 1978;51:843–850.
5.
Canellos GP, Whang-Peng J: Philadelphia-chromosome-positive preleukemic state. Lancet 1972;i:1227–1228.
6.
Aguiar RC, Beitler B, Dorlhiac-Llacer PE, Chamone DA: Secondary chronic myelogenous leukemia: A diverse pathogenesis? Acta Haematol 1994;92:101–103.
7.
Nakamura H, Inokuchi K, Hanawa H, Yamaguchi H, Tamura H, Tajika K, Dan K: A case of chronic myeloid leukemia with minor bcr-abl transcript following fluorouracil therapy for esophageal carcinoma. Ann Hematol 2000;79:396–401.
8.
Pedersen-Bjergaard J, Brondum-Nielsen K, Karle H, Johansson B: Chemotherapy-related and – late-occurring – Philadelphia chromosome in AML, ALL and CML. Similar events related to treatment with DNA topoisomerase II inhibitors? Leukemia 1997;11:1571–1574.
9.
Nandakumar A, Davis S, Moolgavkar S, Witherspoon RP, Schwartz SM: Myeloid leukemia following therapy for a first primary cancer. Br J Cancer 1991;63:782–788.
10.
Swerdlow AJ, Douglas AJ, Hudson GV, Hudson BV, Bennett MH, MacLennan KA: Risk of second primary cancers after Hodgkin’s disease by type of treatment: Analysis of 2,846 patients in the British National Lymphoma Investigation. BMJ 1992;304:1137–1143.
11.
Grünwald H, Rosen F: Chemicals and Leukemia: Leukemia. Philadelphia, Saunders, 1997, pp 179–194.
12.
Kaldor JM, Day NE, Clarke EA, Van Leeuwen FE, Henry-Amar M, Fiorentino MV, Bell J, Pedersen D, Band P, Assouline D: Leukemia following Hodgkin’s disease. N Engl J Med 1990;322:7–13.
13.
Aguiar RC: Therapy-related chronic myeloid leukemia: An epidemiological, clinical and pathogenetic appraisal. Leuk Lymphoma 1998;29:17–26.
© 2003 S. Karger AG, Basel
2003
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.