Reactions 1460, p17 - 13 Jul 2013 S Cladribine Myelodysplastic syndrome in a child: case report A boy developed myelodysplastic syndrome (MDS) while receiving cladribine [2-chlorodeoxyadenosine] for refractory Langerhans cell histiocytosis (LCH). The boy, who was diagnosed with LCH at 1 year of age, achieved complete response after induction chemotherapy, and subsequently completed 1 year of maintenance therapy. One month later, however, his tumour relapsed. He received substitute induction therapy; however, he had further tumour recurrence. He then started receiving cladribine 5 mg/m 2 /day for 5 days every 3 weeks [route not stated]. Six months later, during his seventh administration of cladribine, he gradually developed thrombocytopenia that continued for more than 6 months after the cessation of cladribine. Bone marrow examination revealed neutrophils with pseudo-Pelger anomaly, small round-shaped nuclear megakaryocytes and polynuclear erythroblasts. He was diagnosed with MDS, subtype RAEB-1. Fluorescence in situ hybridisation (FISH) and G-banding revealed chromosomal abnormalities. After 8 months of observation, the boy had persistent thrombocytopenia, and follow-up FISH and G-banding showed worsening of results. He was scheduled to undergo haematopoietic stem cell transplantation; however, 4 months later, his thrombocytopenia gradually improved. His FISH results also improved, and his G-banding became normal. Two years after developing MDS, he achieved haematological remission without any intervention. He had no chromosomal abnormalities, and had remained in complete remission for more than 1 year at last follow-up. Author comment: "Our case developed secondary MDS after treatment with [cladribine] for refractory LCH." Suzuki D, et al. Spontaneous remission of 2-chlorodeoxyadenosine (2-CdA)-related secondary myelodysplastic syndrome in a patient with refractory Langerhans cell histiocytosis. International Journal of Hematology 97: 782-785, No. 6, Jun 2013. Available from: URL: http://dx.doi.org/10.1007/s12185-013-1343-7 - Japan 803089879 1 Reactions 13 Jul 2013 No. 1460 0114-9954/13/1460-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

Cladribine

Download PDF Report

Upload
n-n
View
212
Download
0

Embed Size (px)

Citation preview

Reactions 1460, p17 - 13 Jul 2013

SCladribine

Myelodysplastic syndrome in a child: case reportA boy developed myelodysplastic syndrome (MDS) while

receiving cladribine [2-chlorodeoxyadenosine] for refractoryLangerhans cell histiocytosis (LCH).

The boy, who was diagnosed with LCH at 1 year of age,achieved complete response after induction chemotherapy,and subsequently completed 1 year of maintenance therapy.One month later, however, his tumour relapsed. He receivedsubstitute induction therapy; however, he had further tumourrecurrence. He then started receiving cladribine 5 mg/m2/dayfor 5 days every 3 weeks [route not stated]. Six months later,during his seventh administration of cladribine, he graduallydeveloped thrombocytopenia that continued for more than6 months after the cessation of cladribine. Bone marrowexamination revealed neutrophils with pseudo-Pelgeranomaly, small round-shaped nuclear megakaryocytes andpolynuclear erythroblasts. He was diagnosed with MDS,subtype RAEB-1. Fluorescence in situ hybridisation (FISH) andG-banding revealed chromosomal abnormalities.

After 8 months of observation, the boy had persistentthrombocytopenia, and follow-up FISH and G-bandingshowed worsening of results. He was scheduled to undergohaematopoietic stem cell transplantation; however, 4 monthslater, his thrombocytopenia gradually improved. His FISHresults also improved, and his G-banding became normal. Twoyears after developing MDS, he achieved haematologicalremission without any intervention. He had no chromosomalabnormalities, and had remained in complete remission formore than 1 year at last follow-up.

Author comment: "Our case developed secondary MDSafter treatment with [cladribine] for refractory LCH."Suzuki D, et al. Spontaneous remission of 2-chlorodeoxyadenosine (2-CdA)-relatedsecondary myelodysplastic syndrome in a patient with refractory Langerhans cellhistiocytosis. International Journal of Hematology 97: 782-785, No. 6, Jun 2013.Available from: URL: http://dx.doi.org/10.1007/s12185-013-1343-7 -Japan 803089879