Therapy-related myeloid leukemia

Semin Oncol. 2008 Aug;35(4):418-29. doi: 10.1053/j.seminoncol.2008.04.012.

Abstract

Therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/t-AML) are thought to be the direct consequence of mutational events induced by chemotherapy, radiation therapy, immunosuppressive therapy, or a combination of these modalities, given for a pre-existing condition. The outcomes for these patients have been poor historically compared to people who develop de novo AML. The spectrum of cytogenetic abnormalities in t-AML is similar to de novo AML, but the frequency of unfavorable cytogenetics, such as a complex karyotype or deletion or loss of chromosomes 5 and/or 7, is considerably higher in t-AML. Survival varies according to cytogenetic risk group in t-AML patients, with better outcomes being observed in those with favorable-risk karyotypes. Treatment recommendations should be based on performance status and karyotype. A deeper understanding of the factors that predispose patients to the development of therapy-related myeloid leukemia would help clinicians monitor patients more carefully after treatment for a primary condition. Ultimately, this knowledge could influence initial treatment strategies with the goal of decreasing the incidence of this serious complication.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Chromosome Aberrations
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Leukemia, Myeloid, Acute / etiology*
  • Mutation
  • Neoplasms, Second Primary / genetics*
  • Neoplasms, Second Primary / therapy
  • Radiotherapy / adverse effects
  • Risk Factors
  • Translocation, Genetic
  • Treatment Outcome

Substances

  • Antineoplastic Agents