Acute myeloid leukemia after PARP inhibitor treatment in ovarian cancer-a case report and literature review

Background: Poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors (PARPi) are widely used in the maintenance therapy of ovarian cancer. First -line maintenance therapy with PARPi increases overall survival in patients with ovarian cancer. However, the occurrence of rare and delayed adverse events, including cases of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), should alert researchers and clinicians. Case Description: This study aimed to report a case of a 56 -year -old ovarian cancer patient admitted to our center with a 2 -month history of abdominal distension and a 2 -week history of abdominal pain. She had a family history of esophagus and lung cancer and had germline breast cancer gene 1 gene mutation. Secondary AML developed after second -line treatment using a PARPi following platinum -sensitive recurrence. After 2 months, she died due to hematemesis at home. The possible mechanisms and the clinical features of secondary MDS or AML caused by PARPi have also been discussed after reviewing the literature. Conclusions: Our observations indicate the importance of awareness of secondary MDS or AML that can develop in patients of ovarian cancer treated with PARPi. As PARPi are widely used in ovarian cancer, it is important to evaluate the long-term safety and pay attention to fatal complications.