[Secondary myeloid/natural killer cell acute leukemia appeared in multiple myeloma treated with melphalan].

Abstract

A 67-year-old woman was treated with MP-P therapy and combination chemotherapy for multiple myeloma IgG-lambda type. After the therapy for about three years, pancytopenia developed. Bone marrow aspiration study revealed a few of myeloma cell and many atypical cells showing promyelocytic feature. Chromosomal abnormality was 46, X, -X, +8, -13, +mar. CD33 and CD56 were positive, but CD16 and HLA-DR were negative. We diagnosed as multiple myeloma complicated with secondary myeloid/natural killer (NK) cell acute leukemia. After she had been treated with low dose etoposide for leukemia, she obtained complete remission. But since myeloma progressed and the amount of M protein was increased, she was treated with dexamethasone and low dose etoposide, resulting in a decrease in the amount of M protein. After that, because of leukemic cell re-proliferation, she was treated with etoposide. However, she died of sepsis due to severe myelosuppression. This case was interesting one in coexist of multiple myeloma and secondary myeloid/NK cell acute leukemia, and those affecting her clinical course each other.

• Authors: H Kaya, S Nakamura, H Yamazaki, I Kumabashiri, S Ohtake, T Matsuda
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 36 Issue 7 Pg. 682-6 (Jul 1995) ISSN: 0485-1439 [Print] Japan
• PMID: 7563597 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Etoposide
• Dexamethasone
• Prednisolone
• Melphalan

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Dexamethasone (administration & dosage)
• Etoposide (administration & dosage)
• Fatal Outcome
• Female
• Humans
• Killer Cells, Natural
• Leukemia, Myeloid, Acute (drug therapy, etiology)
• Melphalan (administration & dosage, adverse effects)
• Multiple Myeloma (drug therapy)
• Neoplasms, Second Primary (drug therapy, etiology)
• Prednisolone (administration & dosage, adverse effects)