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  • Title: Therapy-related acute myeloid leukemia after single-agent treatment with fludarabine for chronic lymphocytic leukemia.
    Author: Lam CC, Ma ES, Kwong YL.
    Journal: Am J Hematol; 2005 Aug; 79(4):288-90. PubMed ID: 16044456.
    Abstract:
    A 70-year-old man with B-cell chronic lymphocytic leukemia (CLL) received single-agent treatment with the purine analogue fludarabine, which led to complete remission. After 8 years, he presented with pancytopenia. Marrow examination showed acute myeloid leukemia (AML) with trilineage myelodysplasia (MDS). Cytogenetic analysis showed an unbalanced der(1;7)(p10;q10) that resulted effectively in deletion 7q; confirming the diagnosis of therapy-related AML (t-AML). No residual CLL was present. Together with previous reports of secondary cancers after fludarabine treatment and the association of monosomy 7/7q- with another purine analogue azathioprine, results suggest that t-AML might develop after fludarabine therapy.
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