Abstract
A 44-year-old patient who had had acute monoblastic leukemia developed an osteosarcoma of the pelvic bones 5 years after an allogeneic bone marrow transplant from his HLA-identical sister. He had additionally received superficial cutaneous radiation of the legs and pelvis, over the 3 weeks prior to total body irradiation (TBI), because of cutaneous leukemic lesions. The tumor was a fibrohistiocytomatous osteogenic sarcoma. The first lesion was in the right ilium, and a second lesion appeared 18 months later, symmetrically on the left ilium. Despite treatment, the patient died from metastases. At the time of diagnosis of radiation-induced sarcoma, the patient was free of leukemia and had several risk factors already reported to favor the development of solid tumors in stem cell recipients. These include acute leukemia, TBI and graft-versus-host disease. As he developed symmetrical lesions of the pelvic bone, and because of the histology of the radiation-induced tumor, we assumed that the additional radiation of the skin prior to TBI may have contributed to the pathogenesis of this malignant fibrous histiocytoma. Therefore, the risk/benefit ratio should be carefully considered in unusual indications. These patients should benefit from a close follow-up of the superimposed areas. Bone Marrow Transplantation (2000) 25, 1011–1013.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Bhatia S, Ramsay NKC, Steinbuch M et al. Malignant neoplasms following bone marrow transplantation Blood 1996 87: 3633–3639
Curtis RE, Rowlings PA, Deeg HJ et al. Solid cancers after bone marrow transplantation New Engl J Med 1997 336: 897–904
Deeg HJ, Socie G, Schoch G et al. Malignancies after marrow transplantation for aplastic anemia and Fanconi anemia: a joint Seattle and Paris analysis of results in 700 patients Blood 1996 87: 386–392
Deeg HJ, Socie G . Malignancies after hematopoietic stem cell transplantation: many questions, some answers Blood 1998 91: 1833–1844
Kirova YM, Feuilhade F, Calitchi E et al. Radiation-induced sarcomas following radiotherapy for breast cancer: six case reports and a review of the literature Breast 1998 7: 277–282
Cahan WG, Woodward HQ, Higinbothan NL et al. Sarcoma arising in irradiated bone: report of eleven cases Cancer 1948 1: 3–29
Lowsky R, Lipton J, Fyles G et al. Secondary malignancies after bone marrow transplantation in adults J Clin Oncol 1994 12: 2187–2192
Ishimaru M, Ishimaru T . A review of thirty years study of Hiroshima and Nagasaki atomic bomb survivors. Biological effects. Leukemia and related disorders J Radiat Res 1975 16: (Suppl.) 89–96
Taghian A, de Vathaire F, Terrier P et al. Long-term risk of sarcoma following radiation treatment for breast cancer Int J Radiat Oncol Biol Phys 1991 21: 361–367
Mark PJ, Poen J, Tran LM et al. Postirradiation sarcoma: a single institutional study and review of the literature Cancer 1994 73: 2653–2662
Acknowledgements
The authors thank Dr Isabel Cunningham for her useful comments on the manuscript and Nadine Martin-Garcia for her excellent technical assistance.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kirova, Y., Rafi, H., Voisin, MC. et al. Radiation-induced bone sarcoma following total body irradiation: role of additional radiation on localized areas. Bone Marrow Transplant 25, 1011–1013 (2000). https://doi.org/10.1038/sj.bmt.1702381
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702381
Keywords
This article is cited by
-
Osteosarcoma after allogeneic bone marrow transplantation. A report of four cases from the Cooperative Osteosarcoma Study Group (COSS)
Bone Marrow Transplantation (2003)