Therapy-related acute myelogenous leukemia associated with 11q23 chromosomal abnormalities and topoisomerase II inhibitors: report of four additional cases and brief commentary.
We report 4 additional cases of therapy-related acute myelogenous leukemia (t-AML) with the translocation t(9;11)(p22q23). Chemotherapy for the primary malignancy (breast carcinoma in 2, non-Hodgkin's lymphoma in 2) included agents with topoisomerase II inhibitory activity (doxorubicin in 2; doxorubicin and etoposide in 1; doxorubicin, etoposide and mitoxantrone in 1) as well as alkylators. In agreement with previous reports, the leukemia was monoblastic (FAB M5 subtype) in all 4 patients, with only 1 having prior myelodysplasia, and the latency period from primary therapy was relatively short (24-48 months). All patients received potentially curative treatment for the leukemia which included allogeneic bone marrow transplantation in 3; however, all died (3 of t-AML and 1 of lymphoma). Therapy-related AML associated with exposure to agents with topoisomerase II inhibitory activity (epipodophyllotoxins and anthracyclines) is a distinct entity, the genetic basis and optimal treatment of which remain to be determined.
Bredeson
C N
CN
Leukemia/Bone Marrow Transplantation Program of British Columbia, Vancouver General Hospital, Canada.
Barnett
M J
MJ
Horsman
D E
DE
Dalal
B I
BI
Ragaz
J
J
Phillips
G L
GL
D000328:Adult; D002880:Chromosomes, Human, Pair 11; D002899:Chromosomes, Human, Pair 9; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced / Q000235:genetics*; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000235:genetics*; D059005:Topoisomerase II Inhibitors; D014178:Translocation, Genetic
D059005:Topoisomerase II Inhibitors; D005047:Etoposide