Diagnosis of Therapy-related Acute Myeloid Leukemia with t(8;21)(q22;q22.1) after Treatment for Mantle Cell Lymphoma and Oral Squamous Cell Carcinoma
Patrícia Colombo Corrêa
High Complexity in Health Multi-Professional Internship Program, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Íris Mattos Santos-Pirath
Polydoro Ernani de Sao Thiago University Hospital, Florianópolis, SC, Brazil.
Chandra Chiappin Cardoso
Polydoro Ernani de Sao Thiago University Hospital, Florianópolis, SC, Brazil and Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Camila Mattiolo
Polydoro Ernani de Sao Thiago University Hospital, Florianópolis, SC, Brazil.
Bruno Vieira Dias
Polydoro Ernani de Sao Thiago University Hospital, Florianópolis, SC, Brazil.
Mariana Franzoni Maioral
Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Maria Cláudia Santos-Silva *
Polydoro Ernani de Sao Thiago University Hospital, Florianópolis, SC, Brazil and Department of Clinical Analysis, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: We report a rare case of therapy-related AML with t(8;21)(q22;q22.1) that occurred after treatment for mantle cell lymphoma (MCL) and oral squamous cell carcinoma (OSCC).
Presentation of Case: A 52 years-old male patient was diagnosed with MCL in leukemic phase. The treatment consisted in R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone, then patient experienced remission. Three months later, he presented a lump that was diagnosed as OSCC, which was surgically removed and treated with cisplatin and radiotherapy. Then, the patient’s hemogram presented 35.0% of blasts and, after morphologic, phenotypic and molecular analysis, it was classified as AML with t(8;21)(q22;q22.1). However, due to the previous historic of chemotherapy and radiotherapy, the final diagnosis was t-AML.
Discussion: The correct diagnosis of therapy related malignancies is important due to its severity as they are very aggressive and, usually, considered incurable. t-AMLs with t(8;21)(q22;q22.1) is considered as favorable karyotype, still, it has a poorer outcome compared with its de novo counterpart.
Conclusion: t-AML with t(8;21)(q22;q22.1) is rare and few cases are described in the literature. More reports are necessary to better elucidate the mechanisms involved in this disease to define better treatment strategies to prevent these events and to improve the poor outcomes.
Keywords: Therapy-related neoplasms, mantle cell lymphoma, oral squamous carcinoma, t-AML.