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Tedaviyle İlişkili AML-M4 Gelişen Endometrium Kanserli Bir Olgu

A Case With Treatment Related AML-M4 Developing Endometrium Cancer

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Abstract (2. Language): 
In solid organ tumors, the increasing use of alkalizing agents and topoisomerases have increased the incidence of secondary leukemia in connection with extension of the life expectancy of cancer patients. The treatment related leukemia forms 10-20% of all cases of leukemia. Our case was diagnosed with endometrium cancer in March 2008 and during follow up of sisplatin-doxorubisin-radiotherapy treatment thrombocytopenia was detected. Then upon investigation of the bone marrow material our case was diagnosed with AML M4 based on French American British (FAB) classification AML M4 and then the diagnoses was verified after molecular cytogenetic (FISH) analysis conducted on bone marrow material, since inv 16 was positive. Our patient died in a short time because of complications related to leukemia. If after treatment of primary malign tumors the hematologic conditions are monitored carefully, even for a short term, AML might be detected related to various treatments. To conclude, we consider our case to be of importance since acute leukemia has developed with inv 16 positivity within a very short period of five months after treatment, which is a case rarely observed in the literature.
Abstract (Original Language): 
Solid organ tümörlerinde alkilleyici ajanların ve topoizomerazların yaygın kullanılmaya başlanması kanser hastalarının yaşam süresinin uzamasına bağlı olarak ikincil lösemi insidansını arttırmıştır. Tedavi ilişkili lösemiler tüm lösemilerin yaklaşık %10-20 sini oluşturur. Olgumuz Mart 2008 tarihinde endometrium kanseri tanısı almış olup, sisplatin-doksorubisin-radyoterapi tedavisi sonrası takiplerinde trombositopeni saptandı. Bunun üzerine yapılan kemik iliği materyali değerlendirilmesi sonucunda French American British (FAB) sınıflamasına göre AML M4 tanısı alan olgumuzun kemik iliği materyaline yapılan moleküler sitogenetik (FISH) analizinde de inv 16 pozitif olarak bulularak tanı doğrulandı. Olgumuz, kısa sürede lösemiye bağlı komplikasyonlar nedeniyle kaybedildi. Primer malignitenin tedavisi takibinde kısa süre bile olsa hematolojik durumlar dikkatli olarak incelenirse bir çok tedavi bağımlı AML saptanabilir. Sonuç olarak, tedaviyle ilişkili akut löseminin 5 ay gibi kısa sürede gelişen ve inv 16 pozitif saptanan endometrium kanserli olgumuz, literatürde nadir görülmesi sebebiyle önem taşımaktadır.
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