Treatment-related MDS/AML in a patient after treatment for large-cell neuroendocrine lung cancer

Secondary leukemia is a common late complication after exposure to cancer therapies such as chemotherapy and radiotherapy. With the increase in the overall survival of cancer patients over the past 3 decades, treatment-related malignant neoplasms have increased in incidence. Secondary leukemias due to breast cancer and Hodgkin lymphoma have been studied in detail, but to our knowledge only a few case studies have reported secondary leukemias with previous lung cancer.¹⁻⁴ Lung cancer is the leading cause of cancer death in the United States.⁵ Since the overall survival (OS) as well as the progression-free survival (PFS) of lung cancer has improved, secondary malignancies, which are usually aggressive and have a poor prognosis, have become a common occurrence among survivors. The use of concurrent chemo-radiotherapy could increase the risk for secondary cancers. Here we report the case of a patient who developed treatment-related acute myelogenous leukemia (t-AML) with a likely prior myelodysplasia (t-MDS) after receiving combined chemo-radiotherapy for lung cancer.