Case Report: Leukemia Related to Therapy for Pancreatic Neuroendocrine Tumor
Posted: Wednesday, November 4, 2020
A recent case study, published in Cancer Reports, presented a male patient with a pancreatic neuroendocrine tumor who received peptide receptor radionuclide therapy and developed therapy-related leukemia 60 months after initial treatment. According to Ahmet Emre Eskazan, MD, of Istanbul University‐Cerrahpasa, Turkey, and colleagues, “Patients with therapy-related leukemia are typically at high risk, and their outcomes are inferior [to] those with corresponding de novo cases.” Their findings revealed the patient responded well to tyrosine kinase inhibitor treatment (imatinib), and major molecular responses were achieved after 6 months.
A 64-year-old male patient was diagnosed with a pancreatic neuroendocrine tumor, and his treatment trajectory was followed for 4 years. The patient underwent distal pancreatectomy and splenectomy and abdominal MRI to examine multiple focal lesions of the liver detected after surgery. Over the course of postoperative follow-up, the patient developed persistent leukocytosis and thrombocytosis and was evaluated due to progressive neutrophilic leukocytosis. Peripheral blood samples were collected and used to perform interphase fluorescence in situ hybridization, which was 51.2% positive for chronic myeloid leukemia (CML). Imatinib was administered, and at the 6-month mark, bone marrow aspirates were withdrawn and tested for cytogenetic and major molecular responses.
Bone marrow cytogenetics revealed 46, XY, and tetraploid, with no positive Philadelphia chromosome metaphases. Fluorescence in situ hybridization was negative for t(9;22), and BCR‐ABL1IS was 0.0182%. These findings suggest that complete cytogenetic and major molecular responses were achieved.
“[Peptide receptor radionuclide therapy] is an effective and relatively safe treatment option; however, physicians should be aware of the long‐term hematologic toxicities of this treatment modality including therapy-related CML,” Dr. Eskazan and colleagues concluded.
Disclosure: For full disclosure of the study authors, visit wiley.com.