Secondary acute myelogenous leukemia in patients with retinoblastoma: is chemotherapy a factor?

Ophthalmology. 2007 Jul;114(7):1378-83. doi: 10.1016/j.ophtha.2007.03.074.


Purpose: To describe a series of patients with secondary acute myelogenous leukemia (sAML) and retinoblastoma (RB).

Design: Retrospective observational cases series.

Participants: Ocular and pediatric oncologists at referral centers in Europe and the Americas and the RB databases at the National Institutes of Health and the Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center.

Methods: Physician survey, retrospective database review, and literature search.

Main outcome measures: History of RB and development of sAML, management of RB (surgery, radiotherapy, chemotherapy), age at diagnosis of RB and leukemia, French-American-British (FAB) subtype, and current status of patient (alive or dead).

Results: Fifteen patients with sAML were identified; 13 occurred in childhood. Mean latent period from RB to AML diagnosis was 9.8 years (median, 42 months). Nine cases were of the M2 or M5 FAB subtypes. Twelve patients (79 %) had received chemotherapy with a topoisomerase II inhibitor, 8 (43%) had received chemotherapy with an epipodophyllotoxin. Ten children died of their leukemia.

Conclusions: Acute myelogenous leukemia is a rare secondary malignancy among retinoblastoma patients, many of whom were treated with primary or adjuvant chemotherapy. Additional studies are needed to assess potential risk factors contributing to sAML development in this cohort.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Child, Preschool
  • Cohort Studies
  • Databases, Factual
  • Enzyme Inhibitors / adverse effects*
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Leukemia, Myeloid, Acute / chemically induced*
  • Male
  • Neoplasms, Second Primary / chemically induced*
  • Podophyllotoxin / adverse effects*
  • Podophyllotoxin / therapeutic use
  • Retinal Neoplasms / drug therapy*
  • Retinoblastoma / drug therapy*
  • Retrospective Studies
  • Time Factors
  • Topoisomerase II Inhibitors*


  • Antineoplastic Agents, Phytogenic
  • Enzyme Inhibitors
  • Topoisomerase II Inhibitors
  • Podophyllotoxin