Cisplatin

Abstract

Therapy-related acute myeloid leukaemia: case report A 70-year-old woman developed therapy-related acute myeloid leukaemia (AML) during treatment with cisplatin for locally advanced cancer of the uterine cervix [route and dosage not stated]. The woman, who had locally advanced cancer of the uterine cervix, received radiotherapy and cisplatin with curative intent. One year after cessation of treatment (at the age of 70 years), she was diagnosed to have AML. She had been suffering from dyspnoea, fatigue, headaches and loss of appetite, with functioning in Eastern Cooperative Oncology Group(ECOG) performance status of 1 at the time of AML diagnosis. She underwent investigations. Thrombocytopenia, anisocytosis and neutropenia were detected on peripheral blood smear. The marrow aspirate analysis and flow cytometry were also performed. The findings were noted to be compatible with AML of monocytic lineage [French-American-British (FAB)-classification M5], which was probably a therapy (cisplatin and radiotherapy)-related AML as per the WHO classification. G-banding analysis of bone marrow cells, molecular genetic analysis and nested PCR revealed translocation of t(8;19)(p11;q13) leading to a KAT6A-LEUTX fusion gene. Therefore, the woman was treated with azacitidine [azacitidin] and venetoclax in cycles, which did not induce remission; however, the blood counts improved. After two cycles, she was transfusion independent. Treatments were well-tolerated by her; however, she developed haemorrhagic cystitis, increased transaminase values and reduced kidney function secondary to azacitidine and venetoclax. Therefore, the doses of azacitidine and venetoclax were reduced. At the time of report, she had received six courses of azacitidine and venetoclax, with a stable disease. She had neither achieved remission nor experienced progression.