Acute myeloid leukemia with 11q23/MLL rearrangement after 'FCR' regimen for chronic lymphocytic leukemia

摘要

The regimen of fludarabine, cyclophosphamide, and ritux-imab (FCR) is the standard frontline therapy for physically fit patients with chronic lymphocytic leukemia (CLL) (1). There is growing concern about the leukemogenic potential of fludarabine combination chemotharapy for the treatment of lymphoproliferative disorders (2). Acute myeloid leukemia (AML) with 11q23 abnormalities involving the MLL gene comprises one category of recurring genetic abnormalities in the WHO classification (3). This AML subtype typically evolves within 1-3 years after topoisomerase II inhibitors-containing chemotherapy (4). We report the first case of therapy-related AML with 11q/MLL rearrangement in a CLL patient treated upfront with FCR, a regimen without topoisomerase II inhibitors.