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Annals of Clinical & Laboratory Science 39:392-398 (2009)
© 2009 Association of Clinical Scientists

Case Report

Therapy-Related Myelodysplastic Syndrome/Acute Myeloid Leukemia after Treatment with Temozolomide in a Patient with Glioblastoma Multiforme

Sue Jung Kim1, Tae Sung Park2, Seung Tae Lee3, Jaewoo Song1, Borum Suh1, Se Hoon Kim4, Seon Jung Jang4, Chang Hoon Lee5 and Jong Rak Choi1
Departments of 1 Laboratory Medicine, 3 Internal Medicine, and 4 Pathology, Yonsei University College of Medicine, Seoul, Korea; 2 Laboratory Medicine Department, Kyung Hee University School of Medicine, Seoul, Korea; and 5 Laboratory Medicine Department, Konkuk University College of Medicine, Chungcheongbuk-do, Korea

*Address correspondence to Tae Sung Park, M.D., Ph.D., Department of Laboratory Medicine, Kyung Hee University School of Medicine, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea; tel 822 958 8673; fax 822 958 8609; e-mail 153jesus{at}hanmail.net or 153jesus{at}khmc.or.kr; or Jong Rak Choi, M.D., Ph.D., Department of Laboratory Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea; tel 822 2228 2445; fax 822 313 0956; e-mail cjr0606{at}yuhs.ac.

Therapy-related myelodysplastic syndrome and acute leukemia after treatment with temozolomide have rarely been described in the literature. Only 10 cases in association with temozolomide have been documented. The cases included anaplastic astrocytoma (4 cases), anaplastic oligodendroglioma (2 cases), low grade astrocytoma (2 cases), low grade oligodendroglioma (1 case), and one case of secondary Philadelphia-positive acute lymphoblastic leukemia in a patient with glioblastoma multiforme. Here we report a novel case of therapy-related myelodysplastic syndrome/acute myeloid leukemia associated with der(1;7)(q10;p10) in a glioblastoma multiforme patient treated with temozolomide. Results of bone marrow morphology, chromosome, and fluorescent in situ hybridization (FISH) analyses, as well as the clinical history, strongly suggest a treatment-related etiology in our case. In past reports, karyotypes in cases of therapy-related myelodysplastic syndrome/acute myeloid leukemia mostly demonstrated abnormalities in chromosomes 5 and 7. However, we report a case of temozolomide-related myelodysplastic syndrome/acute myeloid leukemia with der(1;7)(q10;p10), possibly the first reported case, to the authors’ knowledge.

Keywords: myelodysplastic syndrome, acute myeloid leukemia, temozolomide, glioblastoma multiforme






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