Acute leukemia with t(4;11) following treatment for breast cancer

Secondary lymphoid malignancy in two children with neuroblastoma

Secondary lymphoid malignancy, particularly acute lymphoblastic leukemia (ALL), is rare. We report one case of ALL and another case of mediastinal lymphoblastic lymphoma developed after treatment for neuroblastoma. The secondary ALL characterized by short latency period and an 11q23 translocation apparently was induced by etoposide treatment. The pathogenesis of the secondary lymphoma is less certain and may be related to previous treatment with cyclophosphamide and radiotherapy, host susceptibility, or chance occurrence. One child died of progressive lymphoma and the other remains in remission 1 year following allogeneic bone marrow transplantation. Additional studies are needed to determine the risk, pathogenesis, and optimal treatment for secondary lymphoid malignancy.

Secondary acute lymphoblastic leukemia with t (4;11): report on two cases and review of the literature

We report two cases of secondary acute lymphoblastic leukemia (ALL) with t (4;11) (q21;q23) translocation occurring after chemotherapy and radiotherapy for a prior cancer. Seven previously published cases of secondary ALL with t (4;11) (q21;q23) are also reviewed. Most patients had received a combination of topoisomerase II inhibitors (anthracyclines, mitoxantrone, or the epipodophillotoxin derivatives VP16 or VM26) and cyclophosphamide, which have also been implicated in the pathogenesis of secondary acute myeloid leukemia (AML) with 11q23 rearrangements. These observations give further support to the existence of a subgroup of secondary acute leukemias with cytogenetic findings "specific" for de novo ALL and AML, especially those with translocations involving the 11q23 region.

Acute lymphoblastic leukemia with t(4;11) translocation after osteogenic sarcoma

The authors report a case of acute lymphoblastic leukemia (ALL) with t(4;11) (q21;q23) occurring 9 months after treatment of osteogenic sarcoma. Cell surface marker and molecular analyses suggest early B lineage involvement. This is the first report, to the knowledge of the authors, of t(4;11) ALL arising after an osteogenic sarcoma. The observations of the authors support the possibility of a causal relationship between exposure to carcinogens and the occurrence of leukemia with t(4;11).

Acute lymphoblastic leukemia with t(4;11) in a patient previously exposed to a carcinogen

A case of early B t(4;11)(q21;q23) acute lymphoblastic leukemia (ALL) with low white blood cell (WBC) count, without splenomegaly, short survival time, in a patient previously exposed to benzol is presented. We discuss the relationship between the t(4;11)(q21;q23) and the exposure to a carcinogen.

Acute leukaemia with t(4;11) in patients previously exposed to carcinogens

We report three cases of acute leukaemia with t(4;11) (q21;q23), one of them of undifferentiated and the other two of lymphoid phenotype, occurring after adjuvant radiochemotherapy for breast cancer (two cases) or occupational exposure to radiation (one case). Although the myeloid phenotype and characteristic chromosomal anomalies usually observed in secondary leukaemia were lacking, our observations raise the possibility of causal relationship between exposure to carcinogens and the occurrence of a leukaemia with t(4;11).