Remission of acute myelogenous leukemia complicating Waldenstrom macroglobulinemia

The development of acute myelogenous leukemia (AML) in patients with independent hematopoietic disorders has been well documented and recently reviewed. In more than 70 reported cases, multiple myeloma has developed in patients with AML. In most of these cases, the leukemia was preceded by chemotherapy with alkylating agents. AML has also been described in six patients with Waldenstrom macroglobulinemia, a disease similar to multiple myeloma. Before AML developed, five of these patients received chemotherapy for the gammopathy. The acute leukemia complicatng myeloma or Waldenstrom macroglobulinemia has generally been refractory to treatment. In authors' review of the literature, 36 of 74 multiple myeloma patients with AML received antileukemic chemotherapy, with achievement of complete remission in only one patient. Of the six patients with AML complicating Waldenstrom macroglobulinemia, three died without antileukemic treatment and three underwent induction therapy with failure to achieve complete remission. In this report the authors describe attainment of complete remission from AML in a patient with Waldenstrom macroglobulinemia.