Abstract: Although recent advances in combination chemotherapy, high-dose radiotherapy, and combination of chemotherapy and radiotherapy have prolonged the survival time of cancer patients, developments of therapy-related malignancy have increased. We experienced 9 cases of therapy-related leukemia/myelodysplastic syndrome (TRL/TMDS) during the treatment of multiple myeloma (MM). Of 177 MM cases treated with combination chemotherapy for induction or maintenance therapy in our department between 1988 and 2008, 9 cases were diagnosed of TRL/TMDS. There were 6 males and 3 females and the median age at the diagnosis of TRL/TMDS was 69 years (54-78yrs). All 4 cases of TRL were myelogeneous leukemia. In 5 cases of TMDS, there were 2 refractory anemia, 1refractory anemia with excess blasts(RAEB) and 2 chronic myelomonocytic leukemia(CMMoL). In 6 cases, the cumulative dose of melphalan exceeded 800 mg. The remission induction chemotherapy was performed in 3 cases and complete remission was achieved in 1 case and 2 were partial remission. In cases of TMDS, transfusion alone was performed in 2 cases, and controlling the white blood cell count alone in 3cases. Regarding the outcome, the median survival time was 6 months (follow-up period: 1-40 months). One patient have survived for more than 40 months, while 8 cases died caused of TRL or TMDS. The prevention of TRL/TMDS has become an important problem and careful long-term follow-up with periodic blood test is necessary after chemotherapy.

Brief biography of the speaker:
Associate Professor Kazuhiko Natori entered Tokyo college of Pharmacy division of biochemical pharmacy at April 1983 and graduateted at March 1987. In 1989, he entered Toho university school of medicine and gradutated March 1995. Now, he is head of Hematology&Oncology since 2009,and central director of chemotherapy center and chairman of chemotherapy committee since 2010.
He is menber of councile as for Japan Society of Clinical Oncology and Japanese Society of Chemotherapy. Also he is menber of councile as for small study parties. He is mainly related to the chemotherapy whole now. The theme of the research is double cancer, cancer family history and carcinogenesis. He want to amplify knowledge to the chemotherapy whole and to live in the future.