McNew Brandon R, Darbro Benjamin W, Ma Deqin, Gordon David J
*University of Iowa Hospitals and Clinics, Iowa City, IA †Blank Children's Cancer and Blood Disorder Center, Des Moines, IA.
J Pediatr Hematol Oncol. 2017 Oct;39(7):e370-e372. doi: 10.1097/MPH.0000000000000924.
Ewing sarcoma is a pediatric bone and soft tissue sarcoma that requires intensive therapy, which can cause secondary malignancies. We present a rare case of early, treatment-related AML in a pediatric patient concurrently receiving primary therapy for Ewing sarcoma. Despite AML-directed therapy, our patient died secondary to complications of hyperleukocytosis. Cytogenetic and mutation profiling of the leukemia cells revealed the DNA-topoisomerase-II-inhibitor-associated t(9;11)(p22;q23) translocation and clonal KRAS and BRAF mutations. This report highlights the importance of monitoring for treatment-related effects in cancer therapy, as well as the need for novel, less toxic approaches in Ewing sarcoma therapy.
尤因肉瘤是一种儿童骨与软组织肉瘤，需要强化治疗，而这种治疗可能会引发继发性恶性肿瘤。我们报告了一例罕见的病例，一名正在接受尤因肉瘤初始治疗的儿科患者早期发生了与治疗相关的急性髓系白血病（AML）。尽管接受了针对AML的治疗，但我们的患者因高白细胞血症并发症而死亡。白血病细胞的细胞遗传学和突变分析显示存在与DNA拓扑异构酶-II抑制剂相关的t(9;11)(p22;q23)易位以及克隆性KRAS和BRAF突变。本报告强调了在癌症治疗中监测治疗相关效应的重要性，以及在尤因肉瘤治疗中需要新的、毒性较小的方法。
