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Valproic acid has been previously associated with hematologic toxicity,
including a reversible myelodysplasia-like syndrome without chromosomal
abnormalities. We now report three cases of acute leukemia with features of
secondary leukemia associated with valproic acid therapy: two cases of acute
myelogenous leukemia with multilineage dysplasia, one with trisomy 8 and one
with monosomy 7, and one case of secondary acute lymphoblastic leukemia with del
(7) (q22q34), del (9) (q21.11q22), del (11) (q12q23). One patient had a previous
myelodysplastic syndrome while on valproic acid. Valproic acid has been
previously shown to be a histone deacetylase inhibitor.
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