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Therapy-related myelodysplasia and acute myeloid leukemia following paclitaxel- and carboplatin-based chemotherapy in an ovarian cancer patient: a case report and literature review
  1. S. Yeasmin*,
  2. K. Nakayama*,
  3. M. Ishibashi*,
  4. A. Oride*,
  5. A. Katagiri*,
  6. I. N. Purwana*,
  7. K. Iida*,
  8. N. Nakayama*,
  9. H Ishikura and
  10. K. Miyazaki*
  1. * Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane, Japan; and
  2. Department of Oncology, Shimane University School of Medicine, Izumo, Shimane, Japan
  1. Address correspondence and reprint requests to: Kentaro Nakayama, MD, PhD, Department of Obstetrics and Gynecology, Shimane University School of Medicine, Enyacho 89-1, Izumo, Shimane 6938501, Japan. Email: kn88{at}med.shimane-u.ac.jp

Abstract

Alkylating agents have strong leukemogenic potential. There are a number of recent acute myeloid leukemia (t-AML) cases related to previous paclitaxel exposure. These leukemias tend to be of aggressive subtypes with long-latency periods. Unlike previously reported cases, the present case was of the secondary acute megakaryoblastic myeloid leukemia (AML M7) subtype. Additionally, it did not harbor a translocation in chromosome 19. A 73-year-old woman was diagnosed with t-AML M7 with antecedent myelodysplasia. Leukemia followed a second induction of paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer. Her second induction began 25 months after completion of her first course of chemotherapy. The increased incidence of postpaclitaxel leukemia suggests a probable role for paclitaxel as a leukemogenic agent. It highlights the importance of assessing for leukemia risk factors prior to beginning paclitaxel therapy.

  • myelodysplasia
  • paclitaxel
  • secondary leukemia

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