Acute myeloid leukemia post cytotoxic therapy following medulloblastoma in a child successfully treated with a single cycle of CPX-351 followed by stem cell transplantation – a case report

Secondary malignancies are significant complications of childhood cancer treatment. In the pediatric population, their incidence ranges from 3% to 12%, varying based on the primary cancer type and treatment modalities used. Long-term monitoring of childhood cancer survivors facilitates early detection of secondary cancer. The most common secondary malignancy in childhood is acute myeloid leukemia post cytotoxic therapy (AML-pCT). The treatment of AML-pCT is challenging, as the cumulative cytostatic dose (especially anthracyclines) used in the previous therapy and the often already impaired regenerative capacity of the bone marrow and other organ dysfunction should be taken into account. The prognosis of AML-pCT is poorer than AML de novo with the worst outcome in patients with AML following brain tumors as the primary malignancy. Here we present a patient who developed secondary acute myeloid leukemia after completing therapy for medulloblastoma and was successfully treated with a single cycle of liposomal daunorubicin/cytarabine (CPX-351, Vyxeos) followed by hematopoietic stem cell transplantation.