RESUMO
We report a new case of therapy-related acute myeloid leukemia in a child with Langerhans cell histiocytosis. This patient was previously treated with a protocol of multidrug chemotherapy, containing a relatively low dose of etoposide (total dose of 900/m(2)). Twenty-six months after the end of the therapy, the patient returned to the hospital with fever and anemia. The white blood cell count was 53 x 10(9)/L. The bone marrow examination showed massive infiltration with French-American-British acute myeloid leukemia classification M4 blast cells. The patient did not respond to an intensive treatment with high dose ARA-C and idarubicin. He died 6 months later. The cytogenetic abnormality of the blast cells was a t(11;11)(p13 -15;q23), that has not been described before in a secondary leukemia case.
Assuntos
Cromossomos Humanos Par 11/genética , Inibidores Enzimáticos/efeitos adversos , Etoposídeo/efeitos adversos , Histiocitose de Células de Langerhans/tratamento farmacológico , Leucemia Mielomonocítica Aguda/genética , Segunda Neoplasia Primária/genética , Inibidores da Topoisomerase II , Translocação Genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Pré-Escolar , Citarabina/administração & dosagem , Quimioterapia Combinada , Etoposídeo/administração & dosagem , Evolução Fatal , Humanos , Idarubicina/administração & dosagem , Cariotipagem , Leucemia Mielomonocítica Aguda/induzido quimicamente , Leucemia Mielomonocítica Aguda/tratamento farmacológico , Masculino , Segunda Neoplasia Primária/induzido quimicamente , Complexo de Proteínas Formadoras de Poros Nucleares/genética , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Vimblastina/administração & dosagem , Vimblastina/uso terapêuticoRESUMO
In 1985 a new treatment regimen for advanced non-Hodgkin's lymphoma was started in the "Instituto da Criança-HC-FMUSP". The final results are remarkably better than those achieved with former programs. Two cases of children who developed a second neoplasm after the therapy was completed are described and discussed.