Diagnosis of Therapy-related Acute Myeloid Leukemia with t(8;21)(q22;q22.1) after Treatment for Mantle Cell Lymphoma and Oral Squamous Cell Carcinoma

Aims: We report a rare case of therapy-related AML with t(8;21)(q22;q22.1) that occurred after treatment for mantle cell lymphoma (MCL) and oral squamous cell carcinoma (OSCC).

Presentation of Case: A 52 years-old male patient was diagnosed with MCL in leukemic phase. The treatment consisted in R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone, then patient experienced remission. Three months later, he presented a lump that was diagnosed as OSCC, which was surgically removed and treated with cisplatin and radiotherapy. Then, the patient’s hemogram presented 35.0% of blasts and, after morphologic, phenotypic and molecular analysis, it was classified as AML with t(8;21)(q22;q22.1). However, due to the previous historic of chemotherapy and radiotherapy, the final diagnosis was t-AML.

Discussion: The correct diagnosis of therapy related malignancies is important due to its severity as they are very aggressive and, usually, considered incurable. t-AMLs with t(8;21)(q22;q22.1) is considered as favorable karyotype, still, it has a poorer outcome compared with its de novo counterpart.

Conclusion: t-AML with t(8;21)(q22;q22.1) is rare and few cases are described in the literature. More reports are necessary to better elucidate the mechanisms involved in this disease to define better treatment strategies to prevent these events and to improve the poor outcomes.