MLL gene rearrangement in acute myelogenous leukemia after exposure to tegafur/uracil

Successful management of therapy-related chronic myelomonocytic leukemia with cytarabine, aclarubicin, and azacitidine following tegafur/gimeracil/oteracil

A 55-year-old man was diagnosed with therapy-related chronic myelomonocytic leukemia (t-CMML) after exposure to tegafur/gimeracil/oteracil. Although he was refractory to hydroxyurea and low-dose cytarabine, combination therapy with cytarabine, aclarubicin and azacitidine (CA-AZA) provided good disease control, and he underwent allogeneic stem cell transplantation. This report has two key massages. First, tegafur/gimeracil/oteracil may have a potential risk of developing t-CMML. Second, CA-AZA therapy may be considered as a therapeutic option for patients with t-CMML.

S-1 induced secondary acute erythroid leukemia with a chromosome inv(12)(p13;q13)

Adjuvant chemotherapy by S-1 following gastrectomy is considered standard treatment in Japan. Analysis of follow-up data have proved the efficacy of S-1 administration, and that hematological adverse events were relatively rare. Pyrimidine anti-metabolites, including S-1, have shown relatively lower risks for secondary hematological malignancies in comparison to alkylating agents and topoisomerase-II inhibitors. We here report a case of therapy-related leukemia after S-1 administration. A patient who had received S-1as the sole adjuvant chemotherapy was diagnosed with acute erythroid leukemia. To the best of our knowledge, our patient represents the first report of S-1 induced acute leukemia.

Acute myeloid leukaemia secondary to treatment with capecitabine for metastatic colorectal cancer

A 63-year-old woman was diagnosed with acute myelo-monocytic leukaemia, associated with MLL gene rearrangement, 16 months after completion of oral capecitabine for metastatic colon cancer. Capecitabine, recommended for use in metastatic breast and colon cancer and more recently as adjuvant treatment of colon cancer, has not previously been reported to be associated with secondary cancer.

Translocation (13;17)(q14;q25) as a novel chromosomal abnormality in acute myeloid leukemia-M4

We report a case of AML-M4 in which G-band karyotyping revealed a previously unreported t(13;17)(q14;q25) in metaphase preparations. The breakpoints at 13q14 and 17q25 are associated with poor prognosis. The MSF and FKHR genes are located on 17q25 and 13q14, respectively. This report of AML-M4 harboring t(13;17)(q14;q25) as a unique cytogenetic abnormality provides more data on the leukomogenesis with rearrangements related with 13q14 and 17q25.