A case of multiple myeloma terminating in acute promyelocytic leukemia

Abstract

A 56-year-old woman was diagnosed as suffering from stage IIIA multiple myeloma (MM) in January 1993. After 50Gy of radiation therapy, she underwent melphalan•prednisolone (MP) therapy and complete remission was achieved in July 1994. However, after the 16th course of MP therapy (total melphalan dose was 512mg), pancytopenia suddenly developed in September 1994 and acute promyelocytic leukemia (M3 by the FAB classification) was diagnosed with a karyotype of t (15; 17). Low dose Ara-C therapy was not effective and the patient died of sepsis. To our knowledge, this is the first case of M3 type secondary leukemia occuring after melphalan therapy had induced complete remission of MM.