Abstract
Background
Therapy-related acute myeloid leukemia has been widely accepted for decades as one of the most serious long-term complications of treatment for early breast cancer.
Case
We report the case of a patient with therapy-related acute myeloid leukemia that may have been caused by regional radiation, chemotherapy, or endocrine therapy after surgery. A 35-year-old female was diagnosed 7 years ago as having stage IIA left breast cancer; she was treated by conservative surgery, followed by chemotherapy, radiotherapy, and endocrine therapy for 5 years. After 1 year of active follow-up, she presented with complaints of mild fever, weakness, loss of appetite, weight loss, and multiple bruises all over the body. Complete blood count revealed a hemoglobin level of 4 g/dl and total leukocyte count of 40,000 cells/mm3, with multiple blast cells in peripheral smear. Bone marrow biopsy and immunophenotyping established the diagnosis as AML. Before starting the treatment, she died following multiple organ failure.
References
Granfeldt Østgård LS, Medeiros BC, Sengeløv H, et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a national population-based cohort study. J Clin Oncol. 2015;33:3641.
Schaapveld M, Visser O, Louwman MJ, et al. Risk of new primary nonbreast cancers after breast cancer treatment: a Dutch population-based study. J Clin Oncol. 2008;26:1239.
Matesich SM, Shapiro CL. Second cancers after breast cancer treatment. Semin Oncol. 2003;30:740.
Rubagotti A, Perrotta A, Casella C, Boccardo F. Risk of new primaries after chemotherapy and/or tamoxifen treatment for early breast cancer. Ann Oncol. 1996;7:239.
Larson RA. Etiology and management of therapy-related myeloid leukemia. Hematol Am Soc Hematol Educ Progr. 2007;2007:453–9.
Smith RE, Bryant J, DeCillis A, Anderson S. Acute myeloid leukemia and myelodysplastic syndrome after doxorubicin-cyclophosphamide adjuvant therapy for operable breast cancer: the National Surgical Adjuvant Breast and Bowel Project experience. J Clin Oncol. 2003;21:1195–204.
Godley LA, Larson RA. Therapy-related myeloid leukemia. Semin Oncol. 2008;35(4):418–29.
Hershman D, Neugut AI, Jacobson JS, et al. Acute myeloid leukemia or myelodysplastic syndrome following use of granulocyte colony-stimulating factors during breast cancer adjuvant chemotherapy. J Natl Cancer Inst. 2007;99:196–205.
Le Deley MC, Suzan F, Cutuli B, et al. Anthracyclines, mitoxantrone, radiotherapy, and granulocyte colony-stimulating factor: risk factors for leukemia and myelodysplastic syndrome after breast cancer. J Clin Oncol. 2007;25:292–300.
Ono M, Watanabe T, Shimizu C, Hiramoto N, Goto Y, Yonemori K, Kouno T, Ando M, Tamura K, Katsumata N, Fujiwara Y. Therapy-related acute promyelocytic leukemia caused by hormonal therapy and radiation in a patient with recurrent breast cancer. Jpn J Clin Oncol. 2008;38(8):567–70. https://doi.org/10.1093/jjco/hyn057.
Yalcin S, Gullu I, Demiroglu H, Tekuzman G. Acute leukemia during tamoxifen therapy. Med Oncol. 1997;14:61–2.
Rutqvist LE, Johansson H, Signomklao T, Johansson U, Fornander T, Wilking N. Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. J Natl Cancer Inst. 1995;87:645–51.
Early Breast Cancer Trialists’ Collaborative Group. Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet. 1998;351:1451–67.
Haas JF, Kittelmann B, Mehnert WH, Staneczek W, Mohner M, Kaldor JM, et al. Risk of leukaemia in ovarian tumour and breast cancer patients following treatment by cyclophosphamide. Br J Cancer. 1987;55:213–8.
Godley LA, Larson RA. The syndrome of therapy-related myelodysplasia and myeloid leukemia. In: Bennett JM, editor. The myelodysplastic syndromes: pathobiology and clinical management. New York: Marcel Dekker, Inc.; 2002. p. 139–76.
Anderson JE, Gooley TA, Schoch G, et al. Stem cell transplantation for secondary acute myeloid leukemia: evaluation of transplantation as initial therapy or following induction chemotherapy. Blood. 1997;89:2578–85.
Acknowledgements
Special thanks are due to the Faculty of Medicine and Pharmacy of Marrakech and Cadi Ayyad University of Marrakech.
Author information
Authors and Affiliations
Contributions
IL and IE performed the research and wrote the manuscript. RB, AE, and MK coordinated the research and revised and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lalya, I., Essadi, I., Belbaraka, R. et al. Acute Myeloid Leukemia After Treatment of Early Breast Cancer: Case Report and Literature Review. Indian J Gynecol Oncolog 17, 60 (2019). https://doi.org/10.1007/s40944-019-0308-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40944-019-0308-z