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Rare Occurrence of Secondary CML After AML: Case Study

By: Kayci Reyer
Posted: Wednesday, October 28, 2020

A case study published in Current Medical Research and Opinion focused on a unique patient with acute myeloid leukemia (AML) who developed secondary chronic myeloid leukemia (CML) after treatment with autologous hematopoietic stem cell transplantation (auto-HSCT). Although AML commonly follows CML, Waiyi Zou, MD, of Sun Yat-sen University in China, and colleagues noted it is rare for AML to be the primary disease.

“The case expands the understanding of secondary CML and emphasizes the importance of oncological vigilance in patients with secondary CML after AML therapy,” the authors commented.

The patient was initially diagnosed with AML subtype M5b at age 34 in 2011. A combination treatment of mitoxantrone, cytarabine, and etoposide was administered for two courses before a regimen of idarubicin, cytarabine, and etoposide was implemented. Cytarabine was also administered as consolidation chemotherapy. Following these treatment programs, the patient underwent an auto-HSCT with prophylactic intrathecal methotrexate cytarabine and dexamethasone, achieving complete remission in 2012.

After 4 years in remission, the patient presented with an elevation in leukocyte count lasting 4 months, prompting a secondary CML diagnosis. Tyrosine kinase inhibitor therapy was initiated due to the patient’s “severely compromised overall condition.” Imatinib therapy was administered for 18 months. In August 2017, imatinib was replaced by nilotinib. Difficulty controlling the patient’s blood sugar preceded a switch to dasatinib therapy in June 2018. Following this treatment regimen, the patient again achieved remission and remained in remission when the case study was submitted for publication.

Disclosure: The study authors declare no conflicts of interest.

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