Therapy-related acute myeloid leukaemia after successful therapy for acutepromyelocytic leukaemia with t(15;17): a report of two cases and a review of the literature

We describe two patients with positive t(15;17) acute promyelocytic leukaem ia (APL) that developed into a therapy-related myelodysplasia 2-2.5 years a fter complete remission (CR) and then evolved into therapy-related acute my eloid leukaemia (t-AML). Both patients received anthracyclines as potential leukaemogenic drugs. In both cases, cytogenetic changes usually occurring after use of alkylating agents were noticed: monosomy 7 associated with mon osomy 5 or 5q-chromosome. A review of the literature on t-AML occurring aft er successful therapy for APL showed only one report: similar to these two cases. These observations suggest that anthracyclines can cause t-AML simil ar to that induced by alkylating agents.