Acute nonlymphocytic leukemia following bladder instillations with thiotepa

Area of Science:

• Oncology
• Hematology
• Pharmacology

Background:

• Therapy-related acute nonlymphocytic leukemia (ANLL) is a known complication of chemotherapy.
• Alkylating agents, such as thiotepa, are frequently implicated in secondary malignancies.
• Previous reports have associated thiotepa with ANLL following intramuscular administration.

Observation:

• This report details a case of ANLL in a patient who received intravesical thiotepa instillations.
• The patient did not receive intramuscular injections of thiotepa.
• The latency period between the initiation of chemotherapy and the diagnosis of leukemia was 56 months.

Findings:

• This case suggests that intravesical thiotepa administration may also be associated with the development of therapy-related ANLL.
• The findings expand the understanding of potential risks associated with thiotepa, even when administered via a different route.
• The 56-month interval highlights a significant latency period for drug-induced leukemia.

Implications:

• Healthcare providers should consider the risk of secondary leukemia when using intravesical thiotepa.
• Further research may be warranted to elucidate the mechanisms and incidence of ANLL after intravesical thiotepa.
• This case underscores the importance of long-term patient monitoring following chemotherapy, regardless of drug administration route.