Myelodysplastic syndrome and acute nonlymphocytic leukemia secondary to mitolactol treatment in patients with breast cancer.
One thousand four hundred sixty patients with 2,590 patient-years of follow-up were treated on 15 protocols for metastatic breast cancer with dibromodulcitol (mitolactol; DBD)-containing regimens since 1976. Twenty-three patients developed myelodysplastic syndrome (MDS) and/or acute nonlymphocytic leukemia (ANLL). The overall risk of developing MDS or ANLL per person is 1.6%. In patients who had received more than 16,000 mg of DBD the risk per person is 6%, and in the high-dose subsets of patients who received no prior radiation or alkylator therapy, it is 7.9%. The risk per person increases to a maximum by 30 to 36 months (5.3%). The high risk was seen despite a study population of metastatic breast cancer patients with a median survival of 16 months. This analysis strongly suggests that DBD is one of the most potent of the reported leukemogenic-inducing agents. Further use of this drug in both the adjuvant and metastatic situation should be reconsidered.
Falkson
G
G
Department of Medical Oncology, University of Pretoria, Republic of South Africa.
Gelman
R S
RS
Dreicer
R
R
Tormey
D C
DC
Alberts
A S
AS
Coccia-Portugal
M A
MA
Rushing
D
D
Bennett
J M
JM
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000401:mortality; D008875:Middle Aged; D008936:Mitolactol / Q000009:adverse effects*; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000401:mortality; D012306:Risk
D008936:Mitolactol