Table III.
Patients with secondary leukemia (SL) or myelodysplastic syndrome (MDS)
| Neuroblastoma | Leukemia/Myelodysplasia | |||||||
|---|---|---|---|---|---|---|---|---|
| Pa- tient No./Sex |
Age | Induction chemotherapy |
Local radiotherapy |
Other therapy |
Presentation (type) |
Time from start of induction |
Karyotype | Outcome (Time from SL/MDS) |
| 1/M | 12 yr | 8 cycles | none | none | Monocytosis (M4) | 12 mo | 46, XY, del(11) (q23)a | Died of untreated leukemia (14 mo) |
| 2/M | 3 yr | 7 cycles | 2100 cGy to L adrenal | 3F8 | Incidentalb (M2) | 15 mo | 46, XY, del(9) (q13q34), del(11) (q23q25) | Died of LPD post-allograft (7 mo) |
| 3/M | 3 yr | 7 cycles | 2100 cGy to L adrenal | 3F8 | Thrombo- cytopenia (MDS) | 27 mo | 45, XY, del(5) (q11), der(7) t(7;17) (q11;q11), −17 | Allograft (6 mo). Disease-free (170+ mo) |
| 4/M | 3 yr | 7 cycles | 2100 cGy to T2-L1 | 3F8, 131I-3F8 | Leukocytosis (ALL, L2) | 12 mo | 46, XY, t(4;11) (q21;q23) | Died of toxicity post-allograft (6 mo) |
| 5/F | 8 yr | 7 cycles | 2100 cGy to skull & R adrenal | 3F8, 131I-3F8 | Thrombo-cytopenia (MDS) | 50 mo | 46, XX, dic (5;17) (q11.2;p12), der(6) t (6;7)(q13;p11.2), −13, +15, add (19) (q13), −22, +2mar | Died of Sweet syndrome (10 mo) |
| 6/F | 25 yr | 7 cycles | 2100 cGy to L adrenal | 3F8, 131I-3F8 | Thrombo-cytopenia (MDS) | 24 mo | 46, XX, del(7) (q22q32) | Died of NB post-allograft (88 mo) |
| 7/F | 5 yr | 6 cycles | 2100 cGy to R adrenal, skull, L neck, L superior mediastinum | CEM, 3F8, CRA | Thrombo- cytopenia, blasts (AML) | 12 mo | 46, XX, del(11) (p11;p13) | Allograft (8 mo). Disease-free (14+ mo) |
| 8/M | 5 yr | 5 cycles | 2100 cGy to R superior mediastinum & L adrenal | TTC, 3F8, oral etoposide (4 cycles), CRA | Incidentalc (MDS) | 17 mo | 46, XY, t(4;11) (p12;q23)d | Allograft (43 mo). Disease-free (61+ mo) |
ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CEM, carboplatin-etoposide-melphalan with autologous stem-cell rescue; CRA, 13-cis-retinoic acid; LPD, lymphoproliferative disorder; NB, neuroblastoma; TTC, thiotepa-topotecan-carboplatin with autologous stem-cell rescue.
molecular studies revealed a cryptic t(11;17) (q23;p13)31;
a routine bone marrow evaluation for neuroblastoma revealed 30% blasts; peripheral blood counts were unremarkable;
the abnormal karyotype was discovered in a routine bone marrow evaluation for neuroblastoma; bone marrow morphology, the peripheral blood counts, and the mean corpuscular volume were unremarkable;
at 4 months, a clone with t(2;9) (q21;q34) appeared but persisted only 6.5 months