CHEMOTHERAPY-RELATED AND LATE OCCURRING - PHILADELPHIA-CHROMOSOME IN AML, ALL AND CML - SIMILAR EVENTS RELATED TO TREATMENT WITH DNA TOPOISOMERASE-II INHIBITORS

Therapy with DNA topoisomerase II inhibitors has been shown to result in an increased risk of acute myeloid leukemia (AML), often presenting balanced translocations to chromosome bands 11q23 and 21q22. Also oth er balanced aberrations, more rarely observed in therapy-related AML ( t-AML), such as t(15;17) and inv(16) have been associated with these d rugs. Recently we observed a case of chronic myeloid leukemia (CML) wi th t(9;22) after therapy of a germ cell tumor with etoposide, cisplati n and bleomycin. Based on this case and a review of chemotherapy-relat ed leukemias with t(9;22) from the literature, we suggest a causal rel ationship between therapy with DNA topoisomerase II inhibitors and dev elopment of various types of leukemia carrying the Philadelphia chromo some.