Dacarbazine induced acute myeloid leukemia in melanoma.

摘要

Treatment-related acute myeloid leukemia (tAML) is a rarely reported complication of therapy of melanoma. In fact, there are only four cases of tAML or myelodys-plastic syndrome (MDS) in chemotherapy treated melanoma patients reported in English literature. Two cases implicated either fotemustine or melphelan in secondary MDS or tAML [1,2]. A third case reported the combination of fotemustine and 'dacarbazine in association with tAML [3]. Only a single case report, from 1987, implicates single-agent dacarbazine in the development of myeloid leukemia in a melanoma patient [4]. In this case, the additional supporting information implicating the AML or MDS as a secondary process was not available. Cytogenetic analysis, while not essential in differentiating tAML from de novo AML, is still important to support the diagnosis of tAML. Here, we report a classic case of well-documented tAML secondary to dacarbazine, with a classic presentation including secondary trilineage dysplasia, and cytogenetics of tAML occurring secondary to previous alkylating agent therapy.