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Acute myeloid leukemia and colon carcinoma during the course of acromegaly

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Abstract

We describe the case of a 70-year-old male with acromegaly who developed colon carcinoma and myelodysplastic syndrome (MDS) during the course of acromegaly. MDS progressed to acute myeloid leukemia, but was refractory to chemotherapy. Acromegaly is a rare disorder caused by excessive amounts of growth hormone (GH) primarily secreted by pituitary adenomas. Patients with acromegaly are more prone to develop various malignancies, but there are few reports of hematological malignancies in such patients. In the present case, excessive endogenous GH and insulin-like growth factor-I levels may have altered cell proliferation and thereby affected the oncogenesis and chemosensitivity of both malignancies.

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References

  1. Melmed S. Medical progress: acromegaly. N Engl J Med. 2006;355:2558–73.

    Article  PubMed  CAS  Google Scholar 

  2. Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999;2:29–41.

    Article  PubMed  CAS  Google Scholar 

  3. Sekizawa N, Hayakawa E, Tsuchiya K, Yoshimoto T, Akashi T, Fujii T, et al. Acromegaly associated with multiple tumors. Intern Med. 2009;48:1273–8.

    Article  PubMed  Google Scholar 

  4. Watanabe S, Tsunematsu Y, Fujimoto J, Komiyama A, Delemaare-van de Waal HA, Odink RJH, et al. Leukaemia in patients treated with growth hormone. The Lancet. 1988;331(8595):1159–60. doi:10.1016/S0140-6736(88)91968-X.

    Article  Google Scholar 

  5. Endo M, Kaneko Y, Shikano T, Minami H, Chino J. Possible association of human growth hormone treatment with an occurrence of acute myeloblastic leukemia with an inversion of chromosome 3 in a child of pituitary dwarfism. Med Pediatr Oncol. 1988;16:45–7.

    Article  PubMed  CAS  Google Scholar 

  6. Stahnke N. Leukemia in growth-hormone-treated patients: an update, 1992. Horm Res. 1992;38(Suppl 1):56–62.

    Article  PubMed  Google Scholar 

  7. Nishi Y, Tanaka T, Takano K, Fujieda K, Igarashi Y, Hanew K, et al. Recent status in the occurrence of leukemia in growth hormone-treated patients in Japan. GH Treatment Study Committee of the Foundation for Growth Science, Japan. J Clin Endocrinol Metab. 1999;84:1961–5.

    Article  PubMed  CAS  Google Scholar 

  8. Hagg E, Asplund K, Holm J. Acromegaly and multiple myeloma. Ann Intern Med. 1988;109:437–8.

    Article  PubMed  CAS  Google Scholar 

  9. Bengtsson BA, Eden S, Ernest I, Oden A, Sjogren B. Epidemiology and long-term survival in acromegaly. A study of 166 cases diagnosed between 1955 and 1984. Acta Med Scand. 1988;223:327–35.

    Article  PubMed  CAS  Google Scholar 

  10. Barzilay J, Heatley GJ, Cushing GW. Benign and malignant tumors in patients with acromegaly. Arch Intern Med. 1991;151:1629–32.

    Article  PubMed  CAS  Google Scholar 

  11. Ron E, Gridley G, Hrubec Z, Page W, Arora S, Fraumeni JF Jr. Acromegaly and gastrointestinal cancer. Cancer. 1991;68:1673–7.

    Article  PubMed  CAS  Google Scholar 

  12. Beyan C, Ural AU, Cetin T, Ozata M, Yalcin A. Acute promyelocytic leukemia in the course of acromegaly: a case report. Endocr J. 1996;43:565–8.

    Article  PubMed  CAS  Google Scholar 

  13. Popovic V, Damjanovic S, Micic D, Nesovic M, Djurovic M, Petakov M, et al. Increased incidence of neoplasia in patients with pituitary adenomas. The Pituitary Study Group. Clin Endocrinol (Oxf). 1998;49:441–5.

    Article  CAS  Google Scholar 

  14. Au WY, Chow WS, Lam KS, Ko GT, Cockram CS, Kwong YL. Acute leukaemia in acromegaly patients. Br J Haematol. 2000;110:871–3.

    Article  PubMed  CAS  Google Scholar 

  15. Murphy PT, Ahmed N, Hassan HT. Chronic myeloid leukemia and acromegaly in POEMS syndrome. Leuk Res. 2002;26:1135–7.

    Article  PubMed  CAS  Google Scholar 

  16. Schott M, Seissler J, Scherbaum WA. IGF-1, IGFBP-3, and cancer risk. Lancet 2004;364:325 (author reply 26–7).

  17. Sarı R, Demirel U, Sahin İ, Aydoğdu İ, Mızrak B, Taşkapan H. Myelodysplastic syndrome in an acromegaly patient: a case report. Turk J Endocrinol Metab. 2005;3:103–6.

    Google Scholar 

  18. Merchav S. The haematopoietic effects of growth hormone and insulin-like growth factor-I. J Pediatr Endocrinol Metab. 1998;11:677–85.

    Article  PubMed  CAS  Google Scholar 

  19. Doepfner KT, Spertini O, Arcaro A. Autocrine insulin-like growth factor-I signaling promotes growth and survival of human acute myeloid leukemia cells via the phosphoinositide 3-kinase/Akt pathway. Leukemia. 2007;21:1921–30.

    Article  PubMed  CAS  Google Scholar 

  20. Jenkins CR, Shevchuk OO, Giambra V, Lam SH, Carboni JM, Gottardis MM, et al. IGF signaling contributes to malignant transformation of hematopoietic progenitors by the MLL-AF9 oncoprotein. Exp Hematol. 2012;40(715–23):e6.

    PubMed  Google Scholar 

  21. Hattori N, Saito T, Yagyu T, Jiang BH, Kitagawa K, Inagaki C. GH, GH receptor, GH secretagogue receptor, and ghrelin expression in human T cells, B cells, and neutrophils. J Clin Endocrinol Metab. 2001;86:4284–91.

    Article  PubMed  CAS  Google Scholar 

  22. Maki RG. Small is beautiful: insulin-like growth factors and their role in growth, development, and cancer. J Clin Oncol. 2010;28:4985–95.

    Article  PubMed  CAS  Google Scholar 

  23. Pollak MN, Schernhammer ES, Hankinson SE. Insulin-like growth factors and neoplasia. Nat Rev Cancer. 2004;4:505–18.

    Article  PubMed  CAS  Google Scholar 

  24. Tazzari PL, Tabellini G, Bortul R, Papa V, Evangelisti C, Grafone T, et al. The insulin-like growth factor-I receptor kinase inhibitor NVP-AEW541 induces apoptosis in acute myeloid leukemia cells exhibiting autocrine insulin-like growth factor-I secretion. Leukemia. 2007;21:886–96.

    Article  PubMed  CAS  Google Scholar 

  25. Tamburini J, Chapuis N, Bardet V, Park S, Sujobert P, Willems L, et al. Mammalian target of rapamycin (mTOR) inhibition activates phosphatidylinositol 3-kinase/Akt by up-regulating insulin-like growth factor-1 receptor signaling in acute myeloid leukemia: rationale for therapeutic inhibition of both pathways. Blood. 2008;111:379–82.

    Article  PubMed  CAS  Google Scholar 

  26. Wahner Hendrickson AE, Haluska P, Schneider PA, Loegering DA, Peterson KL, Attar R, et al. Expression of insulin receptor isoform A and insulin-like growth factor-1 receptor in human acute myelogenous leukemia: effect of the dual-receptor inhibitor BMS-536924 in vitro. Cancer Res. 2009;69:7635–43.

    Article  PubMed  CAS  Google Scholar 

  27. Frostad S, Bruserud O. In vitro effects of insulin-like growth factor-1 (IGF-1) on proliferation and constitutive cytokine secretion by acute myelogenous leukemia blasts. Eur J Haematol. 1999;62:191–8.

    Article  PubMed  CAS  Google Scholar 

  28. Lacy MQ, Alsina M, Fonseca R, Paccagnella ML, Melvin CL, Yin D, et al. Phase I, pharmacokinetic and pharmacodynamic study of the anti-insulinlike growth factor type 1 Receptor monoclonal antibody CP-751,871 in patients with multiple myeloma. J Clin Oncol. 2008;26:3196–203.

    Article  PubMed  CAS  Google Scholar 

  29. Stein EM, Tallman MS. Remission induction in acute myeloid leukemia. Int J Hematol. 2012;96:164–70.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank Enago (http://www.enago.jp) for English editing services.

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The authors declare no conflict of interest.

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Correspondence to Kazutaka Ozeki.

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Ozeki, K., Morishita, Y., Saito, S. et al. Acute myeloid leukemia and colon carcinoma during the course of acromegaly. Int J Hematol 98, 620–624 (2013). https://doi.org/10.1007/s12185-013-1431-8

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  • DOI: https://doi.org/10.1007/s12185-013-1431-8

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