International Journal of Hematology

, Volume 89, Issue 5, pp 699–703 | Cite as

Therapy related CMML: a case report and review of the literature

  • Faheem Ahmed
  • Nadia Osman
  • Fred Lucas
  • Guy Neff
  • Teresa Smolarek
  • John M. Bennett
  • Rami S. Komrokji
Case Report

Abstract

Therapy related chronic myelomonocytic leukemia (t-CMML) is rare. We report a 23-year-old female who developed acute fulminant hepatic failure after drug overdose. She underwent ABO incompatible orthotopic liver transplant. She received cyclophosphamide along with other immunosuppressants. Seven years later, she was diagnosed with t-CMML-2 with 45XX,-7 karyotype. She received 4 cycles of azacitidine and proceeded with allogeneic bone marrow transplant. This is the first a case of t-CMML reported in a liver transplant recipient. In this article, we also summarize all reported cases of t-CMML, and we review therapy related MDS in recipients of solid organ transplant.

Keywords

CMML Therapy related MDS Liver transplantation 

References

  1. 1.
    Bennett JM, Komrokji R, Kouides P. The myelodysplastic syndromes. In: Abeloff MD, Armitage JO, Niederhuber JE, editors. Clinical oncology, vol. 3rd. New York: Churchill Livingstone; 2004. p. 2849–81.Google Scholar
  2. 2.
    Pedersen-Bjergaard J, Philip P. Two different classes of therapy-related and de novo acute myeloid leukemia? Cancer Genet Cytogenet. 1991;55:119–24. doi: 10.1016/0165-4608(91)90246-Q.PubMedCrossRefGoogle Scholar
  3. 3.
    Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November 1997. J Clin Oncol. 1999;17(12):3835–49.Google Scholar
  4. 4.
    Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias. French–American–British (FAB) co-operative group. Br J Haematol. 1976;33:451–8. doi: 10.1111/j.1365-2141.1976.tb03563.x.PubMedCrossRefGoogle Scholar
  5. 5.
    Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the myelodysplastic syndromes. Br J Haematol. 1982;51:189–99.PubMedGoogle Scholar
  6. 6.
    Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002;100:2292–302. doi: 10.1182/blood-2002-04-1199.PubMedCrossRefGoogle Scholar
  7. 7.
    Komrokji RS, Bennett JM. The clinical implications of the World Health Organization’s classification of myelodysplastic syndromes. Curr Hematol Rep. 2005;4:175–81.PubMedGoogle Scholar
  8. 8.
    Knipp S, Hildebrandt B, Richter J, Haas R, Germing U, Gattermann N. Secondary myelodysplastic syndromes following treatment with azathioprine are associated with aberrations of chromosome 7. Haematologica. 2005;90:691–3.PubMedGoogle Scholar
  9. 9.
    Ueki K, Sato S, Tamura J, et al. Three cases of multiple myeloma developing into melphalan-related chronic myelomonocytic leukemia. J Med. 1991;22:157–61.PubMedGoogle Scholar
  10. 10.
    Oo TH, Kenney L. Therapy-related chronic myelomonocytic leukemia with unique chromosomal abnormalities: monosomy 7 and t(12;17)(p13;q11.2). Am J Hematol. 2007;82:248–9. doi: 10.1002/ajh.20730.PubMedCrossRefGoogle Scholar
  11. 11.
    Kim KB, Faderl S, Hwang CS, Khuri FR. Chronic myelomonocytic leukaemia after platinum-based therapy for non-small cell lung cancer: case report and review of the literature. J Clin Pharm Ther. 2006;31:401–6. doi: 10.1111/j.1365-2710.2006.00748.x.PubMedCrossRefGoogle Scholar
  12. 12.
    Muroi K, Miyata T, Saito M, Hatake K, Amemiya Y, Miura Y. Therapy-related chronic myelomonocytic leukaemia with bone marrow eosinophilia associated with der(11)t(1;11)(q21;q14). Acta Haematol. 1996;96:251–4. doi: 10.1159/000203795.PubMedCrossRefGoogle Scholar
  13. 13.
    Hanto DW, Fecteau AH, Alonso MH, Valente JF, Whiting JF. ABO-incompatible liver transplantation with no immunological graft losses using total plasma exchange, splenectomy, and quadruple immunosuppression: evidence for accommodation. Liver Transpl. 2003;9:22–30. doi: 10.1053/jlts.2003.50011.PubMedCrossRefGoogle Scholar
  14. 14.
    Renard TH, Andrews WS. An approach to ABO-incompatible liver transplantation in children. Transplantation. 1992;53:116–21. doi: 10.1097/00007890-199201000-00022.PubMedCrossRefGoogle Scholar
  15. 15.
    Penn I. Leukemia in the immunosuppressed organ recipient. Ann Thorac Surg. 1994;57:216.CrossRefGoogle Scholar
  16. 16.
    Huebner G, Karthaus M, Pethig K, Freund M, Ganser A. Myelodysplastic syndrome and acute myelogenous leukemia secondary to heart transplantation. Transplantation. 2000;70:688–90. doi: 10.1097/00007890-200008270-00026.PubMedCrossRefGoogle Scholar
  17. 17.
    Kobbe G, Germing U, Aivado M, et al. Treatment of secondary myelodysplastic syndrome after heart transplantation with chemotherapy and nonmyeloablative stem-cell transplantation. Transplantation. 2002;74:1198–200. doi: 10.1097/00007890-200210270-00027.PubMedCrossRefGoogle Scholar
  18. 18.
    Offman J, Opelz G, Doehler B, et al. Defective DNA mismatch repair in acute myeloid leukemia/myelodysplastic syndrome after organ transplantation. Blood. 2004;104:822–8. doi: 10.1182/blood-2003-11-3938.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2009

Authors and Affiliations

  • Faheem Ahmed
    • 1
  • Nadia Osman
    • 1
  • Fred Lucas
    • 2
  • Guy Neff
    • 3
  • Teresa Smolarek
    • 4
  • John M. Bennett
    • 5
  • Rami S. Komrokji
    • 6
    • 7
  1. 1.Hematology and Medical Oncology Division, Department of Internal MedicineUniversity of CincinnatiCincinnatiUSA
  2. 2.Department of PathologyUniversity of CincinnatiCincinnatiUSA
  3. 3.Digestive Disease Division, Department of Internal MedicineUniversity of CincinnatiCincinnatiUSA
  4. 4.Division of Human Genetics, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of MedicineCincinnatiUSA
  5. 5.Department of Medicine, The James P. Wilmot Cancer CenterUniversity of Rochester School of Medicine and DentistryRochesterUSA
  6. 6.Department of Oncologic SciencesUniversity of South FloridaTampaUSA
  7. 7.Department of Hematologic MalignanciesMoffitt Cancer Center and Research InstituteTampaUSA

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