Secondary myelodysplastic syndrome/acute myeloid leukaemia following mitoxantrone-based therapy for breast carcinoma.
Of 1774 patients with breast cancer given mitoxantrone (MTZ) with methotrexate (n = 492) or with methotrexate and mitomycin C (n = 1282), nine developed MDS/AML after a median of 2.5 years. Median duration of survival from diagnosis of MDS/AML was 10 months and six patients died. The crude incidence of developing MDS/AML after MMM or MM chemotherapy was 15 per 100,000 patient years follow-up, while the actuarial risk was 1.1% and 1.6% at 5 and 10 years respectively. MTZ-based regimens carry a 10 x higher risk of subsequent MDS/AML compared to that seen in the general population.
Saso
R
R
Department of Haematology, The Royal Marsden Hospital, Sutton, UK.
Kulkarni
S
S
Mitchell
P
P
Treleaven
J
J
Swansbury
G J
GJ
Mehta
J
J
Powles
R
R
Ashley
S
S
Kuan
A
A
Powles
T
T
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000532:radiotherapy; D003131:Combined Modality Therapy; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D007951:Leukemia, Myeloid / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D007953:Leukemia, Radiation-Induced / Q000453:epidemiology / Q000209:etiology; D015993:Life Tables; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects*; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D011446:Prospective Studies; D012042:Registries; D012306:Risk; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage; D014178:Translocation, Genetic
D013629:Tamoxifen; D016685:Mitomycin; D008942:Mitoxantrone; D008727:Methotrexate