Myelodysplasia Following Treatment of Chronic Lymphocytic Leukaemia with Fludarabine

Recently there has been an increased awareness of a possible link between the use of purine nucleoside analogues and myelodysplasia. We report the case of a patient who developed myelodysplasia with complex cytogenetic changes after receiving fludarabine. We review the literature, discuss the possible links between myelodysplasia and nucleoside analogues and putative mechanisms for secondary neoplasia.