Mitoxantrone-related acute myeloblastic leukaemia in a patient with metastatic hormone-refractory prostate cancer.

Mitoxantrone is a DNA topoisomerase II poison commonly used for the treatment of hormone-refractory prostate cancer. The risk of secondary leukaemia is well described after mitoxantrone treatment in breast cancer and multiple sclerosis. Recent improvements of systemic chemotherapy increased the median survival in patients becoming resistant to androgen deprivation from 10 to 18 months. As a consequence, chemotherapy-related cumulative toxicities may become a more prominent clinical problem in this patient population. We report here the first case report of secondary leukaemia induced by mitoxantrone in metastatic hormone-refractory prostate cancer. This clinical observation invites us to reconsider the number of administrations to be recommended for mitoxantrone-sensitive metastatic prostate cancer patients.