Therapy-related chronic myeloid leukemia in a patient receiving peptide receptor radionuclide therapy for pancreatic neuroendocrine tumor.

Background: Therapy-related leukemia is a well-recognized clinical syndrome. Peptide receptor radionuclide therapy (PRRT) is a modern therapeutic approach using radionuclide combined with somatostatin analog peptide for inoperable or metastatic neuroendocrine tumors.

Aims: Hematologic toxicities including late-onset myeloid neoplasms have been reported after PRRT; however, therapy-related chronic myeloid leukemia (TR-CML) following PRRT is a relatively rare entity.

Methods: We present a 64-year-old male who received PRRT for pancreas neuroendocrine tumor and then developed TR-CML 60 months after the initiation of PRRT. The patient responded well to imatinib therapy.

Results: Patients with TR-CML generally have similar tyrosine kinase inhibitor responses and outcomes when compared to de novo cases.

Conclusions: The physicians should be aware of the short- and long-term hematologic toxicities of PRRT including TR-CML, and careful monitoring is mandatory in this group of patients.