Abstract
BackgroundAlthough the occurrence of acute myeloid leukemia (AML) after chemotherapy for multiple myeloma (MM) is common in clinical settings, the simultaneous occurrence of these malignancies in patients without previous exposure to chemotherapy is a rare event. Etiology, disease management, and clinical treatment remain unclear for this particular occurrence. To the best of our knowledge, this study is the first to report a case of simultaneous presentation of AML and MM after exposure to ultraviolet irradiation.Case presentationWe reported the case of a 73-year-old man (Han Chinese ethnicity) without previous medical history of AML and MM. The morphology and immunology of bone marrow cells confirmed the co-existence of AML and MM. Fluorescent in situ hybridization analysis of immunomagnetically separated abnormal plasma cells showed abnormal expression of the amplified RB-1, TP53, and CDKN2C (1p32). Cytogenetic analysis demonstrated Y chromosome deletion.After the patient was administered with bortezomib combined with cytarabine + aclarubicin + granulocyte colony-stimulating factor (CAG regimen), and evident curative effects were observed. The patient achieved and maintained complete remission for more than 6 months. Prior to the disease occurrence, the patient had received ultraviolet irradiation for 1 year and was detected with aberrant gene expression of RB-1, TP53, and CDKN2C (1p32). Nevertheless, the correlation of this phenomenon with the etiology of concurrent AML with MM remains unclear.ConclusionThis study discussed the case of a patient diagnosed with AML concurrent with MM, who has no previous exposure to chemotherapy. This patient was successfully treated by bortezomib combined with CAG regimen. This study provides a basis for clinical treatment guidance for this specific group of patients and for confirmation of the disease etiology.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1743-6) contains supplementary material, which is available to authorized users.
Highlights
The occurrence of acute myeloid leukemia (AML) after chemotherapy for multiple myeloma (MM) is common in clinical settings, the simultaneous occurrence of these malignancies in patients without previous exposure to chemotherapy is a rare event
This study discussed the case of a patient diagnosed with AML concurrent with MM, who has no previous exposure to chemotherapy
This study provides a basis for clinical treatment guidance for this specific group of patients and for confirmation of the disease etiology
Summary
A patient without previous exposure to chemotherapy was diagnosed with concurrent AML with MM and successfully treated using bortezomib combined with the CAG regimen. This treatment strategy could be a reasonable option for future cases with similar diagnosis. The findings presented in this case report may benefit patients presented abnormal expression of the amplified RB-1, TP53, and CDKN2C (1p32) and the confirmation of the disease etiology (a cheklist item description shows in Additional file 2). (DOC 33 kb) Additional file 2: CARE Checklist. Provided data; all authors were in the interpretation of thee results; WLQ and LH wrote the manuscript; and all authors reviewed and approved the submitted version of the manuscript Authors’ contributions WLQ and LH initiated and designed the study; LXX, LFL, WLL, CXL. and HM. provided data; all authors were in the interpretation of thee results; WLQ and LH wrote the manuscript; and all authors reviewed and approved the submitted version of the manuscript
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