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How breast cancer chemotherapy increases the risk of leukemia: Thoughts about a case of diffuse large B-cell lymphoma and leukemia after breast cancer chemotherapy

View Article: PubMed Central - PubMed

ABSTRACT

The latest studies suggest that prophylactic chemotherapy or adjuvant chemotherapy for early stage breast cancer may increase the leukemia risk in patients. For patients with a low risk for breast cancer recurrence, physicians who make the choice for adjuvant therapy should consider the risk of its long-term side effects. Is the occurrence of lymphatic system cancer and leukemia after breast cancer treatment associated with chemotherapy? Can these types of leukemia be classified as therapy-related leukaemias? We believe that there may be correlations between any diseases, butwe cannot rush to conclusions or dismiss a correlation because we understand little about the diseases themselves.In this paper, we present a case of secondary diffuse large B-cell lymphoma and leukemia in patients after breast cancer chemotherapy, it is undeniable that this is a special event. For two distinct tumouroccurrences at different times, we cannot give a clear explanation because of thechanges in the genes that might link them together and we hope to attract the attention of other clinicians.

No MeSH data available.


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(A) (2007-09-20) Pathological examination revealed a grade II-III invasive ductal carcinoma. (B) (2011-05-12)a left inguinal lymph node revealed a diffuse large B-cell lymphoma. (C) (2011-07-08) Immunotyping showed R2 accounting for 80.77% of the nucleated cells, the expression of CD10(20.91%),CD22(82.24%),CD20(69.85%), CD19(63.50%) and HLA-DR(91.39%). (D) (2011-07-05) Cytological immunotyping examination of the bone marrow morphology showed bone marrow hyperplasia with abnormal lymphoid tissue accounting for 50%, uniform sizes, minimal cytoplasm, blue-colouredcytoplasmwith vacuoles, visibly twisted and folded nuclei, coarse nuclear chromatin and unclear nucleoli. (E) (2011-7-21) Chromosomaltyping showed 46,-X, -1, +7,8q+, -14, -22, +mar2, +mar3, +mar4[5]/46 and xx[5].F:(2011-9-29) A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes.
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f0001: (A) (2007-09-20) Pathological examination revealed a grade II-III invasive ductal carcinoma. (B) (2011-05-12)a left inguinal lymph node revealed a diffuse large B-cell lymphoma. (C) (2011-07-08) Immunotyping showed R2 accounting for 80.77% of the nucleated cells, the expression of CD10(20.91%),CD22(82.24%),CD20(69.85%), CD19(63.50%) and HLA-DR(91.39%). (D) (2011-07-05) Cytological immunotyping examination of the bone marrow morphology showed bone marrow hyperplasia with abnormal lymphoid tissue accounting for 50%, uniform sizes, minimal cytoplasm, blue-colouredcytoplasmwith vacuoles, visibly twisted and folded nuclei, coarse nuclear chromatin and unclear nucleoli. (E) (2011-7-21) Chromosomaltyping showed 46,-X, -1, +7,8q+, -14, -22, +mar2, +mar3, +mar4[5]/46 and xx[5].F:(2011-9-29) A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes.

Mentions: After confirming the diagnosis, the patient received DOCPL(CTX800mg IV d1;Pirarubicin, THP30mg IV d1-3;VCR2mgIV d1, PDN60mg PO Qd d1-5;Lasparaginase,LASPAR 10000U IV Qod×5;q21d ) chemotherapy for a first cycle and with a total of twocycles planned. Due to disease progression, we replaced DOCPL with CTOAP(CTX 1000mg IV d1, THP 40mg IV d1-3;VCR 2mg IV d1, 8;Arabinofuranosylcytosine, Ara-C200mg IV d1-7;PDN 60mg PO Qd d1-14; q21d ) chemotherapy and performed intrathecal injection of methotrexate(MTX) 10 mg + 5 mg dexamethasone in 2 ml of saline to prevent central nervous system leukemia. A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes. The side effects experienced by the patient included level 4 bone marrow suppression, fatigue, weakness and anorexia. The patient refused to continue chemotherapy and received symptomatic supportive treatment before dying in the clinic in February 2012 (Fig. 1).Figure 1.


How breast cancer chemotherapy increases the risk of leukemia: Thoughts about a case of diffuse large B-cell lymphoma and leukemia after breast cancer chemotherapy
(A) (2007-09-20) Pathological examination revealed a grade II-III invasive ductal carcinoma. (B) (2011-05-12)a left inguinal lymph node revealed a diffuse large B-cell lymphoma. (C) (2011-07-08) Immunotyping showed R2 accounting for 80.77% of the nucleated cells, the expression of CD10(20.91%),CD22(82.24%),CD20(69.85%), CD19(63.50%) and HLA-DR(91.39%). (D) (2011-07-05) Cytological immunotyping examination of the bone marrow morphology showed bone marrow hyperplasia with abnormal lymphoid tissue accounting for 50%, uniform sizes, minimal cytoplasm, blue-colouredcytoplasmwith vacuoles, visibly twisted and folded nuclei, coarse nuclear chromatin and unclear nucleoli. (E) (2011-7-21) Chromosomaltyping showed 46,-X, -1, +7,8q+, -14, -22, +mar2, +mar3, +mar4[5]/46 and xx[5].F:(2011-9-29) A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036786&req=5

f0001: (A) (2007-09-20) Pathological examination revealed a grade II-III invasive ductal carcinoma. (B) (2011-05-12)a left inguinal lymph node revealed a diffuse large B-cell lymphoma. (C) (2011-07-08) Immunotyping showed R2 accounting for 80.77% of the nucleated cells, the expression of CD10(20.91%),CD22(82.24%),CD20(69.85%), CD19(63.50%) and HLA-DR(91.39%). (D) (2011-07-05) Cytological immunotyping examination of the bone marrow morphology showed bone marrow hyperplasia with abnormal lymphoid tissue accounting for 50%, uniform sizes, minimal cytoplasm, blue-colouredcytoplasmwith vacuoles, visibly twisted and folded nuclei, coarse nuclear chromatin and unclear nucleoli. (E) (2011-7-21) Chromosomaltyping showed 46,-X, -1, +7,8q+, -14, -22, +mar2, +mar3, +mar4[5]/46 and xx[5].F:(2011-9-29) A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes.
Mentions: After confirming the diagnosis, the patient received DOCPL(CTX800mg IV d1;Pirarubicin, THP30mg IV d1-3;VCR2mgIV d1, PDN60mg PO Qd d1-5;Lasparaginase,LASPAR 10000U IV Qod×5;q21d ) chemotherapy for a first cycle and with a total of twocycles planned. Due to disease progression, we replaced DOCPL with CTOAP(CTX 1000mg IV d1, THP 40mg IV d1-3;VCR 2mg IV d1, 8;Arabinofuranosylcytosine, Ara-C200mg IV d1-7;PDN 60mg PO Qd d1-14; q21d ) chemotherapy and performed intrathecal injection of methotrexate(MTX) 10 mg + 5 mg dexamethasone in 2 ml of saline to prevent central nervous system leukemia. A follow-up examination of the bone marrow cytology showed 73% lymphocytes, including 70.5% immature lymphocytes. The side effects experienced by the patient included level 4 bone marrow suppression, fatigue, weakness and anorexia. The patient refused to continue chemotherapy and received symptomatic supportive treatment before dying in the clinic in February 2012 (Fig. 1).Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

The latest studies suggest that prophylactic chemotherapy or adjuvant chemotherapy for early stage breast cancer may increase the leukemia risk in patients. For patients with a low risk for breast cancer recurrence, physicians who make the choice for adjuvant therapy should consider the risk of its long-term side effects. Is the occurrence of lymphatic system cancer and leukemia after breast cancer treatment associated with chemotherapy? Can these types of leukemia be classified as therapy-related leukaemias? We believe that there may be correlations between any diseases, butwe cannot rush to conclusions or dismiss a correlation because we understand little about the diseases themselves.In this paper, we present a case of secondary diffuse large B-cell lymphoma and leukemia in patients after breast cancer chemotherapy, it is undeniable that this is a special event. For two distinct tumouroccurrences at different times, we cannot give a clear explanation because of thechanges in the genes that might link them together and we hope to attract the attention of other clinicians.

No MeSH data available.


Related in: MedlinePlus