A Case of Secondary Leukemia Having t (9; 11) and MLL Gene Rearrangement Possibly Due to Etoposide

Abstract

We report a case of non-lymphocytic leukemia which was considered to be related to etoposide containing chemotherapy for relapsed acute lymphoblastic leukemia (ALL). A 10-year-old boy was admitted in our department in April 1988 because of bone pain and was diagnosed as having common ALL with normal karyotype. He was treated by our standard risk ALL protocol (UH-8201) until December 1990, but he had bone marrow and testicular relapse 2 months after off-therapy and was treated by the PVDA and BFM rez87 regimen until December 1991. Blast cells appeared in peripheral blood in July 1992. Blast cells in that time changed to monocytoid appearance with t (9; 11) (p22; q23) and the rearrangement of MLL gene. Therefore this case was considered secondary leukemia related to etoposide used in a chemotherapy regimen. The total cumulative dose of etoposide was 1, 060 mg/m².