The successive development of acute myeloblastic leukemia, secondary non-Hodgkin's lymphoma and secondary myeloid/natural killer cell acute leukemia in a single patient

We report a very rare case of a female patient who was initially diagnosed with acute myeloid leukemia (AML) M2 who achieved complete remission (CR) after chemotherapy. Six years later she was still in continuous complete remission from leukemia, but developed a right nasal obstruction and based on the nasal and nasopharynx biopsies, a secondary B cell non-Hodgkin's lymphoma was diagnosed and treated with chemotherapy and involved field radiotherapy. One year and seven months after the completion of therapy she presented with fever, dyspnea and leukocytosis. The blasts were now negative for myeloperoxidase and immunophenotyping showed that they were positive for CD13 and CD56. Now the diagnosis of a secondary myeloid/NK cell acute leukemia was made. The patient died of multiorgan failure 1 month after the onset of leukemia. As far as we know, no other such patient has been described in the English literature until now.