Piszcz Jaroslaw, Bolkun Lukasz, Cichocka Edyta, Kloczko Janusz
Department of Haematology, Medical University of Bialystok, Bialystok, Poland.
Contemp Oncol (Pozn). 2012;16(6):593-5. doi: 10.5114/wo.2012.32497. Epub 2013 Jan 4.
Secondary acute leukaemia (s-ALL) is a destructive complication in patients who have been previously treated for other cancer. Secondary acute lymphoblastic leukaemia is rarely reported whereas secondary acute myeloid leukaemia is much more common. Chromosomal 11q23 abnormality, frequently detected in therapy-related acute myeloid leukaemia, is the most common cytogenetic alteration in secondary ALL too. However, s-ALL cases without 11q23 abnormality have rarely been described. Furthermore, there are only a few published medical reports describing occurrence of acute lymphoblastic leukaemia in multiple myeloma (MM) patients. We would like to present our experience with a patient with MM, who developed ALL without 11q23 abnormality, nine years after alkylating-agent containing treatment. The course of the disease was complicated by thrombosis that obstructed the possibility of effective treatment. In conclusion, it should be kept in mind that the development of a more aggressive neoplasm related to chemotherapy treatment as well as the inherent genetic instability of normal and abnormal lymphoid progenitors may affect overall survival of an indolent lymphoma patient.
继发性急性白血病（s-ALL）是曾接受过其他癌症治疗的患者发生的一种破坏性并发症。继发性急性淋巴细胞白血病鲜有报道，而继发性急性髓系白血病则更为常见。在治疗相关的急性髓系白血病中经常检测到的染色体11q23异常，也是继发性ALL中最常见的细胞遗传学改变。然而，很少有文献描述无11q23异常的s-ALL病例。此外，仅有少数已发表的医学报告描述了多发性骨髓瘤（MM）患者发生急性淋巴细胞白血病的情况。我们想介绍一位MM患者的病例，该患者在接受含烷化剂治疗9年后发生了无11q23异常的ALL。疾病过程因血栓形成而复杂化，阻碍了有效治疗的可能性。总之，应牢记与化疗相关的侵袭性更强的肿瘤的发生以及正常和异常淋巴祖细胞固有的遗传不稳定性可能影响惰性淋巴瘤患者的总生存期。
