A case of treatment-related myelodysplastic syndrome spontaneously resolved by drug discontinuance

• Published in: International journal of hematology Vol. 91; no. 3; pp. 530 - 533
• Main Authors: Nakagawa, Yoshiko, Miura, Katsuhiro, Yamazaki, Tetsuo, Ishizuka, Hikaru, Takei, Kazuhiro, Sawada, Umihiko, Kura, Yoshimasa, Hatta, Yoshihiro, Takeuchi, Jin
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.04.2010; Springer; Springer Nature B.V
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Agents - administration & dosage; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Alkylating - adverse effects; Biological and medical sciences; Case Report; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Female; Hematologic and hematopoietic diseases; Hematology; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Follicular - drug therapy; Medical sciences; Medicine; Medicine & Public Health; Myelodysplastic Syndromes - chemically induced; Oncology; Remission Induction; Rituximab; Young Adult; Secondary MDS; Malignant lymphoma; Cyclophosphamide; Antineoplastic agent; Drug; Secondary; Hematology; Malignant hemopathy; Myelodysplastic syndrome; Alkylating agent; Oxazaphosphinane derivatives; Treatment; Nitrogen mustard; Lymphoproliferative syndrome; Cancer
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-010-0511-2

Although great advancements have been witnessed in treatment results for hematopoietic tumors in recent years, development of secondary malignant tumors induced by anti-cancer drugs still remains a serious issue. We experienced a case of secondary myelodysplastic syndrome (MDS), possibly induced by cyclophosphamide (CY), which was spontaneously resolved by discontinuance of CY. A 24-year-old woman was diagnosed with follicular lymphoma in January 1998: she had developed bulky intra-abdominal lymphadenopathy, with repeated relapse and remission by several chemotherapy treatments. Remission was induced by rituximab, administered at the time of relapse in 2001, followed by administration of 50 mg/day of CY since December 2001 for the prevention of relapse. Anemia and thrombocytopenia developed around January 2003. Bone marrow aspiration revealed abnormality in two lineages and a complicated chromosomal anomaly, and the patient was diagnosed with MDS. Discontinuance of CY and administration of an anabolic steroid improved anemia and thrombocytopenia within 2 years. Bone marrow aspiration in 2006 showed improvement in morphological abnormality and disappearance of chromosomal abnormality.