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The Oncologist, Vol. 11, No. 3, 261-262, March 2006; doi:10.1634/theoncologist.11-3-261
© 2006 AlphaMed Press

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Oxaliplatin-Related Acute Myelogenous Leukemia

Benedito A. Carneiroa, Lynne Kaminera,c, Mohammed Eldibanyb, Chandrika Sreekantaiahd, Karen Kaulb, Gershon Y. Lockera,c

a Department of Medicine, Kellogg Cancer Care Center and b Department of Pathology and Laboratory Medicine, Evanston Northwestern Healthcare, Evanston, Illinois, USA; c Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA; d Dianon Systems (Labcorp), Stratford, Connecticut, USA

Key Words. Oxaliplatin • Acute myelogenous leukemia • Therapy-related leukemia • Colon adenocarcinoma therapy • Chemotherapy side effects

Correspondence: Gershon Y. Locker, M.D., Evanston Northwestern Healthcare, Division of Hematology/Oncology, 2650 Ridge Avenue, Room 5134, Evanston, Illinois 60201, USA. Telephone: 847-570-2515; Fax: 847-570-2336; e-mail: gylocker{at}northwestern.edu

A 56-year-old woman diagnosed with a poorly differentiated cecal adenocarcinoma with metastases to ovaries, omentum, and sigmoid colon went into remission after 12 cycles of infusional 5-fluorouracil, luecovorin, and oxaliplatin (FOLFOX-4 regimen). Thirteen months later, a pelvic recurrence was diagnosed, and the patient received nine cycles of FOLFOX-6 plus bevacizumab, resulting in a clinical complete response but the development of pancytopenia. Bone marrow biopsy was consistent with therapy-related acute myelogenous leukemia. Chromosome analysis showed structural rearrangements with partial deletions of the long arms of chromosomes 5, 7, 20, and 21, as well as trisomy of chromosome 8 and losses of chromosomes 3 and 11. Induction chemotherapy led to remission, but the patient died two months later from complications of colon cancer progression. It is likely that the leukemia was related to the oxaliplatin administration.






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