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Case Report

A Cervical Carcinoma Patient with Therapy-related Myeloid Neoplasm after Chemotherapy and Radiotherapy

Komang Agus Wira Nugraha, Ni Made Renny Anggreni Rena, Herman Saputra.

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The quantity of cancer survivors in developed countries has tripled since 1970 and is growing by 2% each year. The 5-year survival rate of cancer patients is about 66% and in 2004 there were 10 million cancer survivors in the United States. Due to improvements in early detection and treatment, the quantity of patients with multiple cancers is rapidly growing. The rapid improvement of cancer treatment (chemotherapy or radiotherapy) will increase the side effects, such as the emergence of other types of malignancies. Therapy-related myeloid neoplasm (t-MN) consists of therapy-related acute myeloid leukaemia (t-AML) and therapy-related myelodysplastic syndrome (t-MDS). This type of malignancy is raised after treatment with chemotherapy, radiotherapy, immunosuppressive agents, or after documented exposure to environmental carcinogens. We report the case of 49 years old woman with cervical cancer. She was treated by chemotherapy (paclitaxel, carboplatin) and radiotherapy. After about 4 years of initial chemotherapy, she was diagnosed with t-MN (t-AML). Based on the timeline of the event in our patient, we strongly suspected carboplatin, paclitaxel, and radiotherapy as the culprit in the pathogenesis of this myeloid neoplasm. After incomplete induction chemotherapy, she passed away following suspicion of pulmonary leukostasis and septic shock.

Key words: therapy-related myeloid neoplasm, chemotherapy, radiotherapy

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