Diagnosis of myelodysplastic syndromes after cytotoxic therapy for acute myeloid leukemia in the era of molecular research, difficulties in risk stratification and choice of therapy: The first domestic case report and literature review

Abstract

Diagnosis of secondary myeloid neoplasms (therapy-related myeloid neoplasms) associated with therapy of solid tumors, in most cases, is not associated with significant difficulties. The problem is the diagnosis of secondary myelodysplastic syndromes after the treatment of acute myeloid leukaemias. The complexity of early diagnosis of secondary myelodysplastic syndromes is due to the differentiation of this nosology and the early recurrence of previous acute myeloid leukemia and, as a result, the difficulties of prognosis and risk stratification for therapeutic management. The relevance of this problem is explained by the rare case reports. Making the diagnosis of secondary myelodysplastic syndrome, in our opinion, can be based on the absence of a connection of cancer cell clone with the first (previous) disease in a molecular study. In this publication, we describe the first domestic case report of myelodysplastic syndrome diagnosed after chemotherapy for acute myeloid leukemia, based on differences in cytomorphology, immunophenotyping and molecular research. we interpreted the prognosis as favorable and prescribed appropriate treatment.