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Case Reports in Oncological Medicine
Volume 2014, Article ID 361748, 3 pages
http://dx.doi.org/10.1155/2014/361748
Case Report

MYST3/CREBBP Rearranged Acute Myeloid Leukemia after Adjuvant Chemotherapy for Breast Cancer

1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
2Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, USA
3Department of Hematology Oncology, University of Texas Southwestern Medical Center, Seay Biomedical Building, 2201 Inwood Road, Dallas, TX 75390, USA

Received 29 October 2014; Accepted 20 November 2014; Published 8 December 2014

Academic Editor: Sercan Aksoy

Copyright © 2014 Arjun Gupta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although rare, clinicians and patients must be aware that therapy related malignancies, specifically acute myeloid leukemia (AML), can occur as a complication of adjuvant chemotherapy for breast cancer. Vigilance for signs and symptoms is appropriate. AML with t (8;16) is a specific translocation leading to formation of a fusion protein (MYST3/CREBBP). The MYST3/CREBBP AML tends to develop within 2 years of adjuvant chemotherapy, especially for breast cancer, without preceding myelodysplasia. It usually presents with disseminated intravascular coagulation and osteolytic lesions and has a poor prognosis despite aggressive resuscitation and therapy. With the increasing use of adjuvant chemotherapy for breast cancer, we are seeing a definite increase in the incidence of therapy related myelodysplastic syndromes and AML. One must keep this complication in mind while counseling and following up breast cancer patients who have received adjuvant chemotherapy. New osteolytic bone lesions in a patient with history of breast cancer do not necessarily mean metastatic disease and should be fully evaluated.