ACUTE PROMYELOCYTIC LEUKEMIA IN A PATIENT TREATED WITH ETOPOSIDE FOR LANGERHANS CELL HISTIOCYTOSIS

We report a child with acute promyelocytic leukaemia (APL) who was tre ated with etoposide (VP16) for Langerhans cell histiocytosis (LCH). A 3-year-old Japanese girl was diagnosed as having LCH. She was treated with combination chemotherapy using VP16 and prednisolone. 56 months a fter beginning the chemotherapy she developed APL. Her bone marrow was occupied with atypical promyelocytes including giant granules and mul tiple Auer bodies. A cytogenetic analysis of the leukaemic cells showe d 46,XX,11p-,14q+,t(15,17). The cumulative dose of the administered VP 16 was 12120mg/m2, which suggested that VP16 may be responsible for th e development of APL. The risk of developing secondary leukaemia after the administration of VP16 should therefore be considered when managi ng patients with LCH.