AML transformation after autologous stem cell transplant for multiple myeloma.

Abstract

A 59-year-old male patient was diagnosed as multiple myeloma in 2005 and received chemotherapy consisting of thalidomide, cyclophosphamide, and dexamethasone. The patient subsequently received high-dose melphalan followed by autologous stem cell transplantation and maintenance therapy with thalidomide. During the follow-up, the patient developed fever and cytopenias in 2012. The work up revealed 55% blasts in the marrow with myeloid phenotype leading to a diagnosis of acute myeloma leukaemia (AML). The karyotype was normal (46,XY) on conventional cytogenetics. The therapy was initiated, however, the patient expired within 1 month of diagnosis. The treatment related factors like alkylating agents are usually taken as the responsible agents for therapy-related AML, however, recent studies have proposed a multifactorial pathogenesis of leukaemic transformation in multiple myeloma.

• Authors: Sanjeev Kumar Gupta, Jagan Chandramohan, Lalit Kumar
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (May 29 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26025976 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Cell Transformation, Neoplastic
• Follow-Up Studies
• Humans
• Leukemia, Myeloid, Acute (pathology)
• Male
• Middle Aged
• Multiple Myeloma (drug therapy, pathology, therapy)
• Neoplasms, Second Primary (pathology)
• Stem Cell Transplantation (adverse effects, methods)
• Treatment Outcome