Secondary acute myeloid leukemia after double autologous hematopoietic stem cell transplantation for peripheral T-cell non-Hodgkin’s lymphoma: a case report

The paper describes a rare case of secondary acute myeloid leukemia that occurred after double autologous hematopoietic stem cell transplantation (AHSCT) for non-Hodgkin’s lymphoma (NHL). A 46-year-old female was admitted to hospital in June 2000 with a prior history of progressive weakness. On physical examination a general lymphadenopathy and hepatosplenomegaly were present. The diagnosis of peripheral T-cell non-Hodgkin’s lymphoma was made upon the histological examination of the node taken from her neck. The clinical stage was determined as IVB (Ann-Arbor). The patient started chemotherapy with CHOP regimen and after 6 cycles she achieved a complete remission (CR). The first autologous bone marrow transplantation (ABMT) was performed in December 2000 using CBV conditioning. The first relapse occurred two months later and the patient was administered CHOP twice and three cycles of CHOP with bleomycin with CR2 in May 2001. The second autologous peripheral blood stem cell transplantation (APBSCT) was performed in September 2001, after stem cell mobilization with IVE regimen. Conditioning consisted of total body irradiation (TBI) and cyclophosphamide. One year later a second relapse occurred with a general lymphadenopathy and enlargement of lymph nodes in mediastinum. She achieved CR3 in June 2003 after chemotherapy with CMOP and vinblastine with prednisone. In September 2003 her overall condition worsened and the total white cell count increased. She was diagnosed as having acute myeloid leukemia (AML). The patient did not respond to chemotherapy and died of myocardial infarction in October 2003. On autopsy there was no evidence of lymphoma.