Therapy-related myeloid leukemia during erlotinib treatment in a non-small cell lung cancer patient: A case report

Table 1 Literature review findings of therapy-related myeloid neoplasms after epidermal growth factor receptor tyrosine kinase inhibitor treatment in non-small cell lung cancer patients

Patients number	Ref.	Age/sex	Pathological type of NSCLC	Initial stage	EGFR mutation	Prior chemotherapy	Interval from first line treatment	Prior radiotherapy	Duration of EGFR-TKI treatment	Interval from EGFR-TKI treatment until leukemia	CBC profiles at leukemia presentation: WBC (ANC) (μL)-hemoglobin (g/dL)/hematocrit (%)-platelets (mL)	Characteristics (Karyotype) of leukemia/MDS	Survival after diagnosis of leukemia
1	Uchida et al[8], 2005	49/M	Adenocarinoma	IV (T1N0M1)	NA	Cisplatin/docetaxel/ irinotecan 2 cycles	36 mo	Cyberknife for brain metastasis (22.993Gy)	Gefitinib, 15 mo	15 mo	NA	APL, normal karyotype, PML RARα positive	NA
2	Uchida et al[8], 2005	65/M	Squamous cell carcinoma	IIIB (T4N3M0)	NA	Cisplatin/mitomycin/ vinorelbine 2 cycles, Uracil/tegafur for 2 mo in adjuvant setting	48 mo	Fractionated radiotherapy (2Gy* 25)	Gefitinib, 25 mo	25 mo	NA	APL, normal karyotype, PML RARα positive	NA
3	Uchida et al[8], 2005	72/M	Adenocarinoma	IA (T1N0M0)	NA	Carboplatin/paclitaxel 1 cycle, Cisplatin, carboplatin, irinotecan, docetaxel, gemcitabine, vinorelbine, paclitaxel, amrubicin	69 mo	None	Gefitinib, 5 mo + 4 mo (discontinued and restarted)	26 mo	NA	APL, normal karyotype, PML RARα positive	NA
4	Ennishi et al[9], 2006	51/F	Adenocarcinoma	Recurrence after LLL lobectomy, mediastinal LN metastasis	NA	Carboplatin/paclitaxel 6 cycles	NA	Radiotherapy at a total dosage of 60 Gy	Gefitinib, 14 mo	14 mo	2300-13.2/-15200	APL, t(15;17)(q22;q21), PML/RARα positive	NA
5	Stathopoulos et al[6], 2010	67/M	Adenocarinoma	IIIB	NA	Cisplatin/gemcitabine 6 cycles	11 mo	None	Erlotinib, 4 mo	8 mo	Grade 4 thrombocytopenia	MDS, 46, XY, del(20)(q11)[15]/47, idem, + 21(7)/48,idem, 21, + 21[-3]	NA
6	Stathopoulos et al[6], 2010	70/M	Adenocarinoma	IIIB	NA-	Cisplatin/paclitaxel 6 cycles	12 mo	None	Erlotinib, 8 mo	8 mo	WBC 92000	CML, BCR-ABL+	NA
7	Stathopoulos et al[6], 2010	60/F	Adenocarinoma	IIIB	NA	Cisplatin/vinorelbine 6 cycles. Carboplatin/etoposide 3 cycles	36 mo	Radiotherapy (RT) of the primary lung lesions and of themediastinum	Erlotinib, 8.5 mo	8.5 mo	2500-/28.8-72000	MDS, RAEB-T/t-AML, 46, XX, del(7)(q22), add(21)(q22)	Died 3.5 mo later
8	Stathopoulos et al[6], 2010	59/F	Squamous cell carcinoma	IV	NA	Carboplatin/etoposide 6 cycles	14 mo		Erlotinib, 5.5 mo	5.5 mo	3200-/25.7	MDS, RAEB 47, XX, +8, t(5;9)(q13;q34)	Died 8 mo later
9	Moon et al[7], 2014	72/M	Squamous cell carcinoma	II (T2N1M0)	NA	A combination of radiotherapy and a repeated chemotherapy regimen (4 trials, 13 cycles) consisting of docetaxel, cisplatin, gemcitabine, vinorelbine, gefitinib, irinotecan, and carboplatin	10 yr	Combination of radiotherapy and a repeated chemotherapy regimen	Gefitinib, Duration:NA	NA	1700 (780)-5.2/-34000	T-AML (Acute megakaryoblastic leukemia)-5,-7,+2mar	Being followed up
10	Present case	52/M	Adenocarcinoma	IV (T2bN2M1a)	L858R	Paclitaxel/carboplatin 6 cycles, gemcitabin/vinorelbine 3 cycles	20 mo	Cyberknife for brain metastasis (23Gy), WBRT (30Gy)	Erlotinib, 11 mo	11 mo	7600(500)-12.4/-83000	AML, 46, XY, inv(1) (p22q32), inv(16)(p13.1q22)	Died 10 mo later

APL: Acute promyelocytic leukemia; ANC: Absolute neutrophil count; CML: Chronic myeloid leukemia; EGFR: Epidermal growth factor receptor; EGFR-TKI: Epidermal growth factor receptor tyrosine kinase inhibitor; MDS: Myelodysplastic syndrome; NA: Not applicable; NSCLC: Non-small cell lung cancer; RAEB-T: Refractory anemia with excess blasts in transformation; t-AML: Therapy-related acute myeloid leukemia; WBC: White blood cell.