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Development of Secondary Acute Myeloid Leukemia in a Pediatric Patient Concurrently Receiving Primary Therapy for Ewing Sarcoma

McNew, Brandon R. MD*,†; Darbro, Benjamin W. MD, PhD*; Ma, Deqin MD, PhD*; Gordon, David J. MD, PhD*

Journal of Pediatric Hematology/Oncology: October 2017 - Volume 39 - Issue 7 - p e370–e372
doi: 10.1097/MPH.0000000000000924
Online Articles: Clinical and Laboratory Observations

Ewing sarcoma is a pediatric bone and soft tissue sarcoma that requires intensive therapy, which can cause secondary malignancies. We present a rare case of early, treatment-related AML in a pediatric patient concurrently receiving primary therapy for Ewing sarcoma. Despite AML-directed therapy, our patient died secondary to complications of hyperleukocytosis. Cytogenetic and mutation profiling of the leukemia cells revealed the DNA-topoisomerase-II-inhibitor-associated t(9;11)(p22;q23) translocation and clonal KRAS and BRAF mutations. This report highlights the importance of monitoring for treatment-related effects in cancer therapy, as well as the need for novel, less toxic approaches in Ewing sarcoma therapy.

*University of Iowa Hospitals and Clinics, Iowa City, IA

Blank Children’s Cancer and Blood Disorder Center, Des Moines, IA

The authors declare no conflict of interest.

Reprints: Brandon R. McNew, MD, 1200 Pleasant St, Des Moines, IA 50309 (e-mail: Brandon.mcnew@unitypoint.org).

Received December 7, 2015

Accepted May 16, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.