30(03) 255-259
| A Case of Therapy-related ALL with MLL Gene Rearrangement Following
Treatment of Breast Cancer |
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| Jinhee Cho, M.D.1, Mina Hur, M.D1, Hee Won Moon, M.D.1, Yeo-Min Yun, M.D.1, Chang Hoon Lee, M.D.1,
and Hong Ghi Lee M.D.2 | | Departments of Laboratory Medicine1 and Internal Medicine2, Konkuk University School of Medicine, Seoul, Korea | |
| ALL with MLL gene rearrangement secondary to chemotherapy has been rarely reported. We
report a case of therapy-related ALL (t-ALL) with MLL gene rearrangement in a patient who had
undergone treatment for breast cancer. A 60-yr-old woman with breast cancer underwent breastconserving
surgery followed by 6 cycles of adjuvant chemotherapy (cyclophosphamide, epirubicin,
and fluorouracil) and radiation therapy (dose, 5,040 cGy to the left breast and a 1,000 cGy boost to
the tumor bed). A follow-up examination performed 14 months after the chemotherapy revealed no
evidence of breast malignancy. However, the patient’s complete blood cell count indicated acute
leukemia: white blood cell count, 174.1×109/L with 88% blasts; Hb level, 12.5 g/dL; and platelet
count, 103.0×109/L. Examination of the bone marrow aspirate smear revealed a high percentage
of blasts (85.1% of all nucleated cells); the blasts showed a pro-B immunophenotype and were positive
for CD19, CD79a, HLA-DR, CD34, and terminal deoxynucleotidyl transferase (TdT). Cytogenetic
and FISH analyses revealed t(4;11)(q21;q23) and MLL gene rearrangement, respectively. The
patient received induction chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone
and achieved complete remission. Following consolidation chemotherapy, she underwent
allogenic peripheral blood stem cell transplantation and has been clinically stable. To our
knowledge, this is the first reported case of t-ALL with MLL gene rearrangement following treatment
of breast cancer in Korea. (Korean J Lab Med 2010;30:255-9) |
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Korean J Lab Med 2010 Jun; 30(03) 255-259  |
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| DOI No. : 10.3343/kjlm.2010.30.3.255 |
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| Keyword : Therapy, ALL, Topoisomerase II inhibitor, MLL gene rearrangement |
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