An Elderly Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia Case Developed After 3 years of Post-chemotherapy

Introduction: Hematopoietic malignancies may also develop in relation to treatment. Here, we report a case of acute lymphoblastic leukemia that developed in a patient who received chemotherapy and radiotherapy due to gastric cancer about 3 years later.
Case: A patient with known gastric adenocarcinoma received FUFA (5 Fluoro-uracil / leucoverin) weekly for simultaneous radiotherapy after subtotal gasrectomy. Leukocytosis was detected approximately 3 years later and B cell acute lymphoblastic leukemia (B-ALL) was diagnosed. The Philedelphia chromosome t (9; 22) was positive with RT PCR. The patient was given 12 cycles of POMP maintenance + imatinib 600 mg. The patient who had relapse was started on dasatinib treatment.
Discussion: It should be kept in mind that patients with previous chemotherapy may develop ALL instead of MDS and AML.

Kemoradyoterapiden 3 Yýl Sonra Geliþen Ýleri Yaþlý Philadelphia Kromozomu Pozitif Bir Akut Lenfoblastik Lösemi Olgusu

Giriþ: Tedavi iliþkili olarak da hematopoietik maligniteler geliþebilmektedir. Biz burada, mide kanseri nedeni ile kemoterapi ve radyoterapi alan bir olguda yaklaþýk 3 yýl sonra geliþen bir akut lenfoblastik lösemi olgusunu bildirdik.
Olgu: Bilinen mide adenokarsinom tanýsý olan hasta subtotal gasrektomi sonrasýnda radyoterapi ile eþ zamanlý haftalýk FUFA (5 Fluoro-urasil/leucoverin) tedavisi almýþ. Yaklaþýk 3 yýl sonra lökositoz tespit edilen hastaya B hücreli akut lenfoblastik lösemi (B-ALL) tanýsý koyuldu. Philedelphia kromozomu t(9;22) RT PCR ile pozitif saptandý. Hasta 12 kür pomp idame + imatinib 600 mg tedavisi verildi. Nüks olan hastaya dasatinib tedavisine geçildi.
Tartýþma: Daha öncesinde kemoterapi almýþ olan hastalarda MDS ve AML haricinde ALL de geliþebileceði akýlda tutulmalýdýr.