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  • 1 Semmelweis University School 3rd Department of Internal Medicine Kútvölgyi út 4 1125 Budapest Hungary
  • 2 National Medical Center Budapest Hungary
  • 3 Semmelweis University 1st Institute of Pathology and Experimental Cancer Research Budapest Hungary
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Background: Authors report on a patient with monoclonal gammopathy who was misdiagnosed as multiple myeloma and treated with alkylating agent, melphalan. The patient developed myelodysplasia and eventually died of disease complications. The coexistence of myelodysplasia and monoclonal gammopathy and/or multiple myeloma is well known from the literature. The chemotherapy induced secondary myelodysplasia provides a much poorer outcome than that in the two conditions apart from each other. Methods: Authors also present a FISH method successfully applied on plastic embedded archive bone marrow samples for the detection of chromosome alterations. Conclusions: Authors emphasize the importance to follow guidelines when giving chemotherapy, especially melphalan, which is a known inducer of secondary myelodysplasia and leukemia. The FISH method for the detection of chromosome abnormalities described here on archive acrylate embedded bone marrow samples might update earlier findings that have been thought to be lost for scientific workup.

  • Mori, M., Abe, T., Takei, T. et al.: The significance of myelodysplasia in untreated patients with multiple myeloma. Rhinosho-Keutsueki, 1992, 33 , 662–665.

    Takei T. , 'The significance of myelodysplasia in untreated patients with multiple myeloma ' (1992 ) 33 Rhinosho-Keutsueki : 662 -665.

    • Search Google Scholar
  • Auclerc, G., Jacquillat, C., Auclerc, F. et al.: Post-therapeutic acute leukemia. Cancer, 1979, 44 , 2017–2025.

    Auclerc F. , 'Post-therapeutic acute leukemia ' (1979 ) 44 Cancer : 2017 -2025.

  • Advani, S. H., Doval, R. G., Nair, C. N. et al.: Therapy-related leukemia. Oncology, 1983, 40 , 268–272.

    Nair C. N. , 'Therapy-related leukemia ' (1983 ) 40 Oncology : 268 -272.

  • Michels, S. D., McKenna, R. W., Arthur, D. C. et al.: Therapy-related acute myeloid leukemia and myelodysplastic syndrome: A clinical and morphologic study of 65 cases. Blood, 1985, 65 , 1364–1372.

    Arthur D. C. , 'Therapy-related acute myeloid leukemia and myelodysplastic syndrome: A clinical and morphologic study of 65 cases ' (1985 ) 65 Blood : 1364 -1372.

    • Search Google Scholar
  • Curtis, R. E., Boice, J. D., Stovall, M. et al.: Risk of leukemia after chemotherapy and radiation treatment for breast cancer. New Eng. J. Med., 1992, 326 , 1745–1751.

    Stovall M. , 'Risk of leukemia after chemotherapy and radiation treatment for breast cancer ' (1992 ) 326 New Eng. J. Med. : 1745 -1751.

    • Search Google Scholar
  • Raposa, T., Várkonyi, J.: The relationship between sister chromatid exchange induction and leukemogenecity of different cytostatics. Cancer Detect. Prev., 1987, 10 , 141–151.

    Várkonyi J. , 'The relationship between sister chromatid exchange induction and leukemogenecity of different cytostatics ' (1987 ) 10 Cancer Detect. Prev. : 141 -151.

    • Search Google Scholar