International Journal of Hematology

, Volume 75, Issue 1, pp 67–71 | Cite as

Therapy-Related Myelodysplastic Syndrome in a Case of Cutaneous Adult T-Cell Lymphoma

  • Naofumi Fukuda
  • Kenji Shinohara
  • Ituro Ota
  • Kazuhiko Muraki
  • Yoko Shimohakamada
Case Report


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 words

Cutaneous adult T-cell lymphoma Radiation Chemotherapy Therapy-related MDS 


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  1. 1.
    Pedersen-Bjergaard J, Rowley JD. The balanced and the unbalanced chromosome aberration may develop in different ways and may contribute differently to malignant transformation.Blood. 1994;83:2780–2786.PubMedGoogle Scholar
  2. 2.
    Takeyama K, Seto M, Uike N, et al. Therapy-related leukemia and myelodysplastic syndrome: a large-scale Japanese study of clinical and cytogenetic features as well as prognostic factors. Int J Hematol. 2000;71:144–152.PubMedGoogle Scholar
  3. 3.
    Nakamura H, Ishizaki T, Itoyama T, et al. Acute myeloid leukemia with t(9;11)(p22;q23) in a patient treated for adult T cell leukaemia.Br J Haematol. 1994;86:222–224.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Tsukasaki K, Koba T, Iwanaga M, et al. Possible association between adult T-cell leukemia/lymphoma and acute myeloid leukemia.Cancer. 1998;82:488–494.CrossRefPubMedGoogle Scholar
  5. 5.
    Kawabata H, Utsunomiya A, Handa S, et al. Myelodysplastic syndrome in a patient with adult T-cell leukaemia.Br J Haematol. 1999;106:702–705.CrossRefPubMedGoogle Scholar
  6. 6.
    Yamamoto K, Seto M, Iida S, et al. A reverse transcriptase- polymerase chain reaction detects heterogeneous chimeric m-RNA in leukemia with 11q23 abnormalities.Blood. 1994;83:2912–2921.PubMedGoogle Scholar
  7. 7.
    Hellstrom-Lindberg E, Willman C, Barrett AJ, et al. Achievements in understanding and treatment of myelodysplastic syndromes.Hematology 2000. Washington, DC: The American Society of Hematology; 2000:110–132.Google Scholar
  8. 8.
    Misawa S, Horiike S. TP53 mutation in myelodysplastic syndrome.Leuk Lymphoma. 1996;23:417–422.CrossRefPubMedGoogle Scholar
  9. 9.
    Ben-Yehuda D, Krichevsky S, Capsi O, et al. Microsatellite instability and p53 mutations in therapy-related leukemia suggest muta- tor phenotype.Blood. 1996;88:4296–4303.PubMedGoogle Scholar
  10. 10.
    Sakashita A, Hattori T, Miller C W, et al. Mutations of the p53 gene in adult T-cell leukemia.Blood. 1992;79:477–480.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Hirai H, Kobayashi Y, Mano H, et al. A point mutation at codon 13 of the N-ras oncogene in myelodysplastic syndrome.Nature. 1987;327:430–432.CrossRefPubMedGoogle Scholar
  12. 12.
    Horiike S, Misawa S, Nakai H, et al. N-ras mutation and karyotypic evolution are closely associated with leukemic transformation in myelodysplastic syndrome.Leukemia. 1994;8:1331–1336.PubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Naofumi Fukuda
    • 1
  • Kenji Shinohara
    • 1
  • Ituro Ota
    • 1
  • Kazuhiko Muraki
    • 1
  • Yoko Shimohakamada
    • 1
  1. 1.Division of Hematology, Department of MedicineYamaguchi Prefecture Central HospitalHofuJapan

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