levoleucovorin and Chromosome-Deletion

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Capecitabine; Carcinoembryonic Antigen; Chemotherapy, Adjuvant; Chromosome Deletion; Chromosome Disorders; Chromosomes, Human, Pair 18; Colonic Neoplasms; Colonoscopy; Deoxycytidine; Early Detection of Cancer; Europe; Female; Fluorouracil; Follow-Up Studies; Humans; Intestinal Mucosa; Leucovorin; Lymphatic Metastasis; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Occult Blood; Organoplatinum Compounds; Oxaloacetates; Risk; Risk Assessment; Risk Factors; Sigmoidoscopy; Treatment Outcome

A 56-year-old woman diagnosed with a poorly differentiated cecal adenocarcinoma with metastases to ovaries, omentum, and sigmoid colon went into remission after 12 cycles of infusional 5-fluorouracil, luecovorin, and oxaliplatin (FOLFOX-4 regimen). Thirteen months later, a pelvic recurrence was diagnosed, and the patient received nine cycles of FOLFOX-6 plus bevacizumab, resulting in a clinical complete response but the development of pancytopenia. Bone marrow biopsy was consistent with therapy-related acute myelogenous leukemia. Chromosome analysis showed structural rearrangements with partial deletions of the long arms of chromosomes 5, 7, 20, and 21, as well as trisomy of chromosome 8 and losses of chromosomes 3 and 11. Induction chemotherapy led to remission, but the patient died two months later from complications of colon cancer progression. It is likely that the leukemia was related to the oxaliplatin administration.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Cecal Neoplasms; Chromosome Deletion; Female; Fluorouracil; Humans; Leucovorin; Leukemia, Myeloid, Acute; Middle Aged; Omentum; Organoplatinum Compounds; Ovarian Neoplasms; Peritoneal Neoplasms; Sigmoid Neoplasms; Trisomy

A decrease of frequency of a gap at the extremity of the long arm of the X chromosome (fragile site Xq27) is obtained by adjonction of monocarbons precursors to lymphocytes cultures. The efficacity of the treatments is precised by the analysis of 44 629 mitoses. For the first time, in one patient, parenteral administration of 5-formyl-tetrahydrofolate lead to a clinical improvement with concomitant disappearance of the gap.

Topics: 5-Hydroxytryptophan; Amino Acids; Aminolevulinic Acid; Cells, Cultured; Child; Chromosome Deletion; Female; Humans; Hydroxyproline; Leucovorin; Lymphocytes; Male; Mitosis; Sex Chromosome Aberrations; X Chromosome