The occurrence of myelodysplastic syndrome or acute myeloid leukemia has been reported after treatment with cytotoxic alkylating agent-based chemotherapy for solid tumors. We report a 50-year-old woman presented with abdominal distension, vomiting, and fatique. The abdominal tomography showed bilaterally ovarian masses and ascite. Surgery was performed and histopathology of the ovarian mass revealed moderately differentiated papillary adenocarcinoma of ovarian. The patient was treated with chemotherapy combination including paclitaxel and carboplatin for six cycles. At 4 years after chemotherapy, recurrence of the primary disease developed. She received carboplatin and paclitaxel. Two years later, complete blood count showed leukocyte count 15.700 /mm3 (15% myeloblasts), hemoglobin 8.7 g/dL, and platelet count 88.000 /mm3. Bone marrow examination and flow cytometry analysis were consistent with acute myeloid leukemia. Standard induction chemotherapy with idarubicin and cytosine arabinoside was administered with failure to achieve complete remission. At the follow-up, the patient died due to prolonged febrile neutropenia. In conclusion, patients who were treated with high dose or long term alkylating agents should particularly follow-up for secondary tumors.
Keywords: Ovarian carcinoma, chemotherapy, alkylating agents, acute myeloid leukemia