Acute leukemia arising from a myelodysplastic syndrome after long-term administration of iproplatin.

Abstract

Iproplatin (cis-dichloro-transdihydroxybis-isopropylamine platinum IV; CHIP) is a second generation cisplatin derivative that was developed to retain the antineoplastic effect of cisplatin with fewer toxic effects. Early clinical studies showed moderate activity in some neoplasms, with disappointing results in tumors of the lower gastrointestinal tract. Myelosuppression was the dose-limiting toxic effect in the acute setting. The authors report a patient with metastatic adenocarcinoma of the colon who received long-term therapy with CHIP. The patient achieved complete remission of disease after prolonged treatment with CHIP. The patient subsequently had a myelodysplastic syndrome that rapidly transformed to acute myelogenous leukemia. Acute leukemia may represent a late complication of CHIP therapy.