Therapy-Related Acute Myeloid Leukemia with 11q23 Abnormality Coexisting with Refractory Metastatic Ewing Sarcoma: Report of a Case and Review of the Literature

• Published in: Pediatric and developmental pathology Vol. 13; no. 1; pp. 50 - 54
• Main Authors: Worcester, Heath D., Vasef, Mohammad A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2010; SAGE PUBLICATIONS, INC
• Subjects: Adolescent; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biomarkers, Tumor - metabolism; Bone Marrow - pathology; Bone Neoplasms - drug therapy; Bone Neoplasms - genetics; Bone Neoplasms - pathology; Chromosomes, Human, Pair 11; Humans; Leukemia, Myeloid, Acute - chemically induced; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - pathology; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Neoplasm, Residual - pathology; Sarcoma, Ewing - drug therapy; Sarcoma, Ewing - genetics; Sarcoma, Ewing - secondary; Toes - pathology; Toes - surgery; Translocation, Genetic; intensified chemotherapy; Ewing sarcoma; therapy-related AML; topoisomerase II inhibitors
• ISSN: 1093-5266; 1615-5742
• DOI: 10.2350/09-03-621-CR.1

Intensified chemotherapy is one of the strategies currently used in the treatment of children with metastatic Ewing sarcoma. However, the increasing dose intensity has not significantly improved the event-free survival. We report a patient who initially presented with localized Ewing sarcoma and later developed metastatic disease that required dose-intensified chemotherapy. The patient's Ewing sarcoma remained refractory to treatment despite continuous intensified chemotherapy and was complicated by a therapy-related acute myeloid leukemia with 11q23 abnormality. Examination of bone marrow at the last clinical follow up demonstrated both acute myeloid leukemia and residual metastatic Ewing sarcoma.