Abstract
A case of acute promyelocytic leukemia following etoposide-based combination chemotherapy for Letterer-Siwe disease is reported. The patient was a 3-year-4-month-old girl who had been treated with vincristine, cyclophosphamide, methotrexate, prednisolone and etoposide because of Letterer-Siwe disease diagnosed by bone marrow examination and lymph node biopsy at the age of 5 moths. The total cumulative dose of etoposide was 4, 800 mg/m2. She had remained well for 9 months after completion of chemotherapy. Then she came to our hospital with fever and purpura. Bone marrow examination confirmed a diagnosis of acute promyelocytic leukemia. The bone marrow karyotype was 46, XX, t (15; 17) (q22, q12). She was treated with BFM-83 protocol and attained remission after induction chemotherapy. But she died of heart failure after one year of consolidation chemotherapy. The risk of developing secondary leukemia in high-dose etoposide therapy is discussed.
