161 Therapy-Related Acute Erythroid Leukemia After Olaparib Treatment. (11th January 2018)

• Record Type: Journal Article
• Authors: Liu, Xin; Wang, Endi
• Is Part Of: American journal of clinical pathology. Volume 149(2018)Supplement 1
• Page Start: S69
• Page End: S69
• Publication Date: 2018-01-11
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqx121.160
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Introduction: Acute erythroid leukemia (AEL) is rare, accounting for <5% of acute myeloid leukemias (AMLs). The 2016 World Health Organization classification of myeloid neoplasms merged erythroleukemia with myelodysplastic syndrome (MDS) and retained the pure erythroid leukemia (PEL) type of AEL. PEL is defined as >80% immature erythroid precursors with ≥30% proerythroblasts. It commonly has a very complex karyotype and an extremely aggressive clinical course. PEL has recently been approved in metastatic prostate cancer with DNA-repair defects. Rare cases of, MDS/AML have been reported following treatment with olaparib. Here we reported a unique case of therapy-related PEL following olaparib treatment. Clinical History: A 69-year-old man had prostatic carcinoma, and was treated with androgen deprivation and radiation therapy. Two years later, he received multiple-agent chemotherapy for recurrent prostatic carcinoma, including olaparib (1.5 years), docetaxel, and Taxotere (three cycle). One year later, he developed sudden onset of pancytopenia, fever, elevated LDH, and transaminitis. His bone marrow biopsy was diagnosed as PEL, with >80% of early erythroid precursors and significant hemophagocytic lymphohistiocytosis. Cytogenetic studies showed a complex karyotype. The patient deceased within one week of admission due to multiorgan failure. Conclusions: MDS and AML are rare adverse events after olaparib regimen. However, all the patients reported had been heavily pretreated with other cytotoxic agents, and thus the determinant is difficult to decide. The interesting points in this case are as follows: (1) the patient is mainly treated with olaparib for 1.5 years before development of PEL; (2) to the best of our knowledge, this is the first report of PEL associated with olaparib therapy.