Therapy-related myelodysplasia and acute myeloid leukemia following paclitaxel- and carboplatin-based chemotherapy in an ovarian cancer patient: a case report and literature review

Int J Gynecol Cancer. 2008 Nov-Dec;18(6):1371-6. doi: 10.1111/j.1525-1438.2007.01185.x. Epub 2008 Jan 23.


Alkylating agents have strong leukemogenic potential. There are a number of recent acute myeloid leukemia (t-AML) cases related to previous paclitaxel exposure. These leukemias tend to be of aggressive subtypes with long-latency periods. Unlike previously reported cases, the present case was of the secondary acute megakaryoblastic myeloid leukemia (AML M7) subtype. Additionally, it did not harbor a translocation in chromosome 19. A 73-year-old woman was diagnosed with t-AML M7 with antecedent myelodysplasia. Leukemia followed a second induction of paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer. Her second induction began 25 months after completion of her first course of chemotherapy. The increased incidence of postpaclitaxel leukemia suggests a probable role for paclitaxel as a leukemogenic agent. It highlights the importance of assessing for leukemia risk factors prior to beginning paclitaxel therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / blood
  • Carboplatin / therapeutic use*
  • Female
  • Humans
  • Karyotyping
  • Leukemia, Myeloid, Acute / blood
  • Leukemia, Myeloid, Acute / chemically induced*
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / pathology
  • Myelodysplastic Syndromes / blood
  • Myelodysplastic Syndromes / chemically induced*
  • Myelodysplastic Syndromes / complications*
  • Myelodysplastic Syndromes / pathology
  • Ovarian Neoplasms / drug therapy*
  • Paclitaxel / therapeutic use*


  • Biomarkers, Tumor
  • Carboplatin
  • Paclitaxel