IMPLICATION OF PRIOR TREATMENT WITH DRUG-COMBINATIONS INCLUDING INHIBITORS OF TOPOISOMERASE-II IN THERAPY-RELATED MONOCYTIC LEUKEMIA WITH A 9-11 TRANSLOCATION

The present case, together with other reports reviewed herein, defines a new subtype of therapy‐related acute myeloid leukemia (t‐AML). This variant of t‐AML is characterized by a short interval from initial drug therapy to bone marrow dysfunction and monocytic morphology without trilineage dysplasia. Unlike classic t‐AML, which frequently has abnormalities of chromosomes 5 and/or 7, this new subtype is characterized by rearrangements involving band q23 of chromosome 11, most commonly a 9;11 translocation. The majority of patients with this subtype of t‐AML had prior cytotoxic therapy with topoisomerase II‐reactive drugs including anthracyclines, epipodophyllotoxins, or actinomycin D, combined with either an alkylating agent or cisplatin. This association of prior therapy which includes topoisomerase II‐reactive agents and a rapidly appearing t‐AML involving the monocytic line and chromosome 11 requires additional study. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company