Therapy-related acute myeloid leukemia with t(9;11)(p22;q23) translocation that developed in a woman with metachronous bilateral breast cancer

Abstract

We describe a 64-year-old woman who developed metachronous bilateral breast cancer. At 22 months after epirubicin-based chemo-radiotherapy for the second such cancer, she developed acute myeloid leukemia (AML). The leukemic cells were monoblastic and carried a t(9;11)(p22;q23) translocation involving the MLL gene, determined by conventional cytogenetic analysis and fluorescence in situ hybridization. These findings are consistent with the features of therapy-related AML induced by treatment with DNA topoisomerase II inhibitors; epirubicin was the most likely causative chemotherapeutic agent. The patient responded to induction and consolidation chemotherapy for AML, and attained complete remission. She exhibited various arrhythmias, however, including ventricular tachycardia, which may have been due to the effects of anthracyclines.