MYELODYSPLASTIC SYNDROME PRESENTING AS 3RD MALIGNANCY AFTER NON-HODGKINS-LYMPHOMA AND OSTEOSARCOMA

The patient was initially diagnosed as having non-Hodgkin's lymphoma a nd was cured following treatment with prednisolone, vincristine, dauno rubicin, 1-asparaginase, and cyclophosphamide. Seven years and two mon ths later, he developed osteosarcoma in his right femur. He received c hemotherapy consisting of methotrexate, carboplatin, etoposide, and if osfamide and again obtained remission. After 2 years and 7 months, how ever, he was found to have pancytopenia with morphological abnormaliti es in the erythroid and myeloid series. Diagnosis of myelodysplastic s yndrome (MDS) was made. Cytogenetic analysis of bone marrow cells reve aled -5 and -7, which is typical for secondary MDS. This is a rare cas e of third malignancy presumably caused by alkylating agents.