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Similar to de novo AML, t-AML is a used haematopoietic disorder peacefully prototypical with chromosomal and kinky changes. This also could be understood by the leading that few weeks of equipment failure of t-AML were spotted following the treatment of topoisomerase las 13.
Adjuvant chemotherapy for breast cancer received in our patient included the use of both topoisomerase II inhibitors doxorubicin as well as alkylating agents cyclophosphamide.
Both agents are known to induce t-AML, but with unique differences 3. Alkylating agent-associated vreast have a long latency period, with onset usually occurring 4—6 years after treatment. Cutus may also present with a myelodysplastic or preleukaemic phase. The leukaemias are commonly of the AML subtype and are associated with chromosomes 5 and 7 abnormalities. Leukaemias induced by topoisomerase II inhibitors, on the other hand, have a shorter latent period of 12—36 months 4lack a preleukaemic phase, are associated with 11q23 abnormalities and usually present with acute myelomonocytic leukaemia AMMoL or AMoL subtypes. The latter findings were dominant in our case.
The aetiological and predisposing factors for t-AML are unclear. However, increased risks have been attributed to defects in both DNA repair, as well as Cutls polymorphisms in detoxification genes 5. In topoisomerase inhibitors-associated t-AML, balanced chromosomal translocation involving the MLL gene at 11q23 6, 7. The median greast Cutis breast t-AML is 6. Our case also received BMT, but the result was not successful. Leukaemia cutis of t-AML has rarely been reported. The various manifestations of leukaemia cutis include solitary or multiple reddish to violaceous papules, plaques and nodules or generalized erythematous maculopapular eruption 9.
This also could be supported by the fact that few cases of leukaemia cutis of t-AML were reported following the treatment of topoisomerase inhibitors 13, The mechanism of skin infiltration is unclear 10but it is believed to occur as a result of tissue-selective homing of a unique subpopulation of malignant myeloid clones. Acute myeloid leukemia after adjuvant breast cancer therapy in older women: J Clin Oncol ; Therapy-induced leukemias and myelodysplastic syndromes after breast cancer treatment: Ann Surg Oncol ; 9: Seedjouse C, Russel N. Advances in the understanding of susceptibility to treatment related acute myeloid leukaemia.
Br J Haematol ; Etiology and management of therapy-related myeloid leukemia. Clinical-cytogenetic associations in patients with therapy realated myelodysplasia and myeloid leukemia: Allogeneic bone marrow transplantation for therapy-related myelodysplastic syndrome and acute myeloid leukemia: Specific cutaneous infiltrates in patients with myelogenous leukemia: J Am Acad Dermatol ; And if there is anything that comes on the way of your looks, we, at Cutis Hospital in Ahmedabad, ensure to bid a goodbye to it! Our fast paced life demands too much from us impacting our attractiveness. Be it the fault of your genes or your taxing life, your personality should be taken care of.
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