A Case of Therapy-related ALL with MLL Gene Rearrangement Following Treatment of Breast Cancer.
10.3343/kjlm.2010.30.3.255
- Author:
Jinhee CHO
1
;
Mina HUR
;
Hee Won MOON
;
Yeo Min YUN
;
Chang Hoon LEE
;
Hong Ghi LEE
Author Information
1. Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net
- Publication Type:Case Report
- Keywords:
Therapy;
ALL;
Topoisomerase II inhibitor;
MLL gene rearrangement
- MeSH:
Antibiotics, Antineoplastic/therapeutic use;
Blood Cell Count;
Bone Marrow/pathology;
Breast Neoplasms/*drug therapy/radiotherapy;
Chemotherapy, Adjuvant;
Combined Modality Therapy;
Cyclophosphamide/therapeutic use;
Cytogenetic Analysis;
Epirubicin/therapeutic use;
Female;
Fluorouracil/therapeutic use;
Gene Rearrangement;
Hematopoietic Stem Cell Transplantation;
Humans;
In Situ Hybridization, Fluorescence;
Myeloid-Lymphoid Leukemia Protein/*genetics;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*etiology/genetics/pathology;
*Translocation, Genetic
- From:The Korean Journal of Laboratory Medicine
2010;30(3):255-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
ALL with MLL gene rearrangement secondary to chemotherapy has been rarely reported. We report a case of therapy-related ALL (t-ALL) with MLL gene rearrangement in a patient who had undergone treatment for breast cancer. A 60-yr-old woman with breast cancer underwent breast-conserving surgery followed by 6 cycles of adjuvant chemotherapy (cyclophosphamide, epirubicin, and fluorouracil) and radiation therapy (dose, 5,040 cGy to the left breast and a 1,000 cGy boost to the tumor bed). A follow-up examination performed 14 months after the chemotherapy revealed no evidence of breast malignancy. However, the patient's complete blood cell count indicated acute leukemia: white blood cell count, 174.1x10(9)/L with 88% blasts; Hb level, 12.5 g/dL; and platelet count, 103.0x10(9)/L. Examination of the bone marrow aspirate smear revealed a high percentage of blasts (85.1% of all nucleated cells); the blasts showed a pro-B immunophenotype and were positive for CD19, CD79a, HLA-DR, CD34, and terminal deoxynucleotidyl transferase (TdT). Cytogenetic and FISH analyses revealed t(4;11)(q21;q23) and MLL gene rearrangement, respectively. The patient received induction chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone and achieved complete remission. Following consolidation chemotherapy, she underwent allogenic peripheral blood stem cell transplantation and has been clinically stable. To our knowledge, this is the first reported case of t-ALL with MLL gene rearrangement following treatment of breast cancer in Korea.
