Secondary chronic myelogenous leukemia after chemotherapy followed by adjuvant radiotherapy for small cell lung cancer

A 40-year old patient with small cell lung cancer (SCLC) was treated with c ombined modalities including high-dose chemotherapy with subsequent autolog ous peripheral blood progenitor cell transplantation plus adjuvant radiothe rapy. He achieved complete remission with regards to the primary disease. A fter an interval of 28 months, he was diagnosed with chronic myelogenous le ukemia (CML). Analysis of graft samples at time of primary treatment for SC LC using polymerase chain reaction (PCR) did not show the bcr-abl transcrip t characteristic for CML. This case supports the observation that CML can d evelop as a treatment-related malignancy and gives insight in the length of the preclinical phase of the disease. (C) 1999 Elsevier Science Ltd. All r ights reserved.