CORRESPONDENCE CASE REPORT Transient therapy-related myelodysplastic syndrome associated with monosomy 7 and 11q23 translocation

Secondary acute myelocytic leukemia (AML) and myelodyspl- one associated with monosomy 7 and the other with the astic syndromes (MDS) are known to develop in patients pre- 11q23 translocation, who had a spontaneous hematological viously treated with different chemotherapeutic regimens. Non- and cytogenetic remission without any therapeutic interrandom chromosomal abnormalities have been demonstrated vention. in these therapy-related myeloid disorders which often evolve into refractory AML. The prognosis of these patients with conventional chemotherapy has been dismal and only allogeneic bone marrow transplantation offers a potential cure. We Case reports describe two patients who developed MDS after chemo/ radiotherapy and had a spontaneous recovery. One patient was Patient 1 treated with MOPP-ABVD hybrid therapy for Hodgkin’s disease, developed pancytopenia, marrow hypoplasia and dyserythroA 15-year-old black female initially presented with progresspoiesis associated with monosomy 7. The other was treated with a combination of chemotherapy including VP-16 for ive cervical lymphadenopathy for 3 weeks, weight loss of 10% Ewing’s sarcoma, developed thrombocytopenia, marrow hypo- total body weight, and night sweats. Chest CT showed mulplasia and dyserythropoiesis associated with an 11q23 translo- tiple nodes in her neck and chest as well as in the peritracheal cation. Both patients received rhG-CSF after their cycles of region. A bone marrow aspiration and biopsy were negative chemotherapy and were considered for a bone marrow trans- for extrinsic or abnormal cells. Lymph node biopsy revealed plant. Marrow aspirates at frequent intervals showed gradual nodular sclerosing Hodgkin’s disease. She was treated with disappearance of the abnormal clone with parallel normalization of the peripheral count. In both patients G-CSF might four cycles of nitrogen mustard, vincristine, procarbazine, have played a role in the development of the abnormal clone. prednisone and four cycles of doxorubicin, bleomycin, vinblaWe suggest that patients with therapy-related MDS without stin, DTIC (MOPP-ABVD hybrid chemotherapy) as well as excess of blasts could be closely monitored for karyotypic 3000 cGy to the involved fields. Due to neutropenia after the and hematological improvement rather than transplanted first course, the patient received rhG-CSF after each subimmediately. sequent cycle. Upon completion of her treatment she was in