The development of therapy-related acute myeloid leukemia (t-AML) has
become a growing concern over the past decade, because of the increase
in the percentage of long-term survivors of primary malignancy. We re
viewed 17 cases with etoposide-related acute promyelocytic leukemia (A
PL) reported in the literature. The close association between treatmen
t with etoposide for Langerhans cell histiocytosis (LCH) and the devel
opment of etoposide-related APL was demonstrated among Japanese and It
alians. Our data on the breakpoints (b/ps) of the PML and RAR alpha ge
nes are presented. It is suggested that chromatin structure might be m
ore important than specific consensus sequence in the distribution of
b/ps in etoposide-related APL.