Essential Thrombocythemia and Multiple Myeloma: Two Rare Diseases in One Patient

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 11; no. 5; pp. 442 - 445
• Main Authors: Eskazan, Ahmet Emre, Ongoren, Seniz, Ar, Muhlis Cem, Soysal, Teoman, Ferhanoglu, Burhan, Aki, Hilal, Aydin, Yildiz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2011
• Subjects: Disease Progression; Essential thrombocythemia; Fatal Outcome; Female; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Multiple myeloma; Multiple Myeloma - complications; Multiple Myeloma - diagnosis; Multiple Myeloma - therapy; Neoplasm Staging; Thrombocythemia, Essential - complications; Thrombocythemia, Essential - diagnosis; Thrombocythemia, Essential - therapy; Essential thrombocythemia; Multiple myeloma
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/j.clml.2011.04.001

Essential thrombocythemia has been associated with transformation to acute myeloid leukemia, myelodysplastic syndrome, chronic lymphocytic leukemia, and other MPNs, especially primary myelofibrosis. The association between multiple myeloma (MM) and ET is infrequent. We report a patient who developed MM nearly 3 years after the diagnosis of ET while she was receiving hydroxyurea (HU) treatment and successfully autotransplanted but relapsed and died of the disease progression. There are only 2 cases documented in the literature who received HU alone for the treatment of ET and then developed MM. As far as we know our patient is the third patient that is documented in the literature who had received HU for ET and then developed MM. A successful stem cell mobilization was performed with chemotherapy and granulocyte colony-stimulating factor and thereafter she was autografted. ? Treatment related malignancy can be a possible explanation in this kind of patient. Proliferation of a pluripotent neoplastic stem cell with a capacity to differentiate into both lymphoid and myeloid cells can be another hypothesis. The interleukin-6 (IL-6) may also provide an association between MM and ET. IL-6 is a potent human myeloma-cell growth factor and overproduction of IL-6 is important in the pathogenesis of MM. IL-6 is known to promote megakaryocytopoiesis and can play a role in the pathogenesis of essential thrombocythemia. The pathogenetic interactions between IL-6 and the putative pluripotent stem cell implicated in the pathogenesis of the coexistent cases of ET and MM needs to be further established.