AML transformation after autologous stem cell transplant for multiple myeloma. (29th May 2015)

• Record Type: Journal Article
• Authors: Gupta, Sanjeev Kumar; Chandramohan, Jagan; Kumar, Lalit
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-05-29
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2015-210024
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 59-year-old male patient was diagnosed as multiple myeloma in 2005 and received chemotherapy consisting of thalidomide, cyclophosphamide, and dexamethasone. The patient subsequently received high-dose melphalan followed by autologous stem cell transplantation and maintenance therapy with thalidomide. During the follow-up, the patient developed fever and cytopenias in 2012. The work up revealed 55% blasts in the marrow with myeloid phenotype leading to a diagnosis of acute myeloma leukaemia (AML). The karyotype was normal (46, XY) on conventional cytogenetics. The therapy was initiated, however, the patient expired within 1 month of diagnosis. The treatment related factors like alkylating agents are usually taken as the responsible agents for therapy-related AML, however, recent studies have proposed a multifactorial pathogenesis of leukaemic transformation in multiple myeloma.