Multiple myeloma preceding myelodysplastic syndrome with eosinophilia and der (1;7)

Multiple myeloma (IgG kappa + IgA kappa type, clinical stage IA) was diagnosed in a 82-year-old woman in January 1986. Chemotherapy (melphalan, prednisolone, vindesine, cyclophosphamide), caused prolonged myelosuppression. Therefore she was given other treatment. In October 1992, her peripheral blood examination demonstrated 2% blastic cells and 12% eosinophils. Bone marrow aspiration showed dysplastic features of trilineage blood cells with 4.8% myeloblasts. The karyotype of bone marrow cells from this patients was 47, XX, +der(1)t(1;7) (p11;p11), -7, +8. A diagnosis of therapy-related myelodysplastic syndrome (refractory anemia) was established. Eleven months after diagnosis of myelodysplastic syndrome, she is alive without leukemic transformation.