melphalan and Eosinophilia

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.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chromosomes, Human, Pair 1; Chromosomes, Human, Pair 7; Cyclophosphamide; Eosinophilia; Female; Humans; Melphalan; Multiple Myeloma; Myelodysplastic Syndromes; Prednisolone; Translocation, Genetic; Vindesine

A 47-year-old woman developed a unique myeloproliferative disorder 36 months after receiving adjuvant chemotherapy postoperatively for breast carcinoma. Her bone marrow and peripheral blood exhibited many of the myelodysplastic changes commonly observed in treatment-linked leukemia. In addition, there was striking marrow and blood eosinophilia and eosinophilic infiltration in multiple organs. She also developed a poorly differentiated lymphocytic lymphoma which responded to therapy. Her myeloproliferative disorder, with marked eosinophilia, continued to progress, however, and she died shortly after its diagnosis.

Topics: Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cyclophosphamide; Doxorubicin; Eosinophilia; Female; Humans; Lymphoma, Non-Hodgkin; Mastectomy; Melphalan; Middle Aged; Myeloproliferative Disorders; Prednisone; Vincristine

Topics: Eosinophilia; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma

Scleromyxedema (generalized lichen myxedematosus) is a rare variant of papular mucinosis characterized clinically by generalized waxy papules and marked cutaneous induration. Histologically, there is fibromucinous infiltration of the superficial dermis. Most patients also have had a monoclonal serum protein of cathodal mobility. The case to be presented is remarkable for the following reasons: 1. the presence of esophageal aperistalsis; 2. the presence of prominent dermal eosinophilia; and 3. the absence of a serum monoclonal paraprotein.

Topics: Adult; Deglutition Disorders; Eosinophilia; Humans; Male; Melphalan; Paraproteins; Skin Diseases