Therapy-Related Myelodysplastic Syndrome in a Case of Cutaneous Adult T-Cell Lymphoma
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We report a case of therapy-related myelodysplastic syndrome (t-MDS) in adult T-cell lymphoma. A 69-year-old man suffered from cutaneous adult T-cell lymphoma, which was treated with radiation to the skin and combination chemotherapy of CHOP-V-MMV and VEPA-B.After 14 months of these therapies, anemia and thrombocytopenia appeared, and bone marrow aspiration smears showed immature myeloblasts, dysplastic erythroblasts, and micromegakaryocytes. Therapy-related MDS of refractory anemia with an excess of blasts was diagnosed. Cytogenetic study of the bone marrow cells showed 5q— and additional abnormalities. Rearrangement of the MLL gene was observed in the bone marrow cells. Mutations of N-ras codons at 12, 13, and 61, p53 tumor suppressor gene, and monoclonal integration of human T-lymphotrophic virus —1 provirus DNA were not observed in the bone marrow cells.The patient died of pneumonia 21 months after diagnosis of cutaneous adult T-cell lym-phoma.
Key wordsCutaneous adult T-cell lymphoma Radiation Chemotherapy Therapy-related MDS
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