title: Treatment-related myelodysplasia following fludarabine combination chemotherapy.
abstract: Although myelodysplasia (MDS) and secondary acute myeloid leukemia (sAML) are rare following fludarabine monotherapy, the risk of these diseases may potentially be increased when fludarabine is combined with cyclophosphamide or mitoxantrone due to synergistic effects on the inhibition of DNA repair. Among 137 patients treated with fludarabine combination regimens, ten patients developed MDS/sAML, including one who had received no other therapy. Six patients had abnormalities of chromosomes 5 and/or 7. The crude rate of MDS/sAML was 2.5% for previously untreated patients, and 9.3% for pretreated patients (p=0.28). The rate of MDS/sAML following fludarabine combination therapy is higher than that previously reported for fludarabine monotherapy.
authors.affiliation: Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Constantine S
authors.initials: CS
authors.lastname: Tam
authors.forename: John F
authors.initials: JF
authors.lastname: Seymour
authors.forename: H Miles
authors.initials: HM
authors.lastname: Prince
authors.forename: Melita
authors.initials: M
authors.lastname: Kenealy
authors.forename: Max
authors.initials: M
authors.lastname: Wolf
authors.forename: E Henry
authors.initials: EH
authors.lastname: Januszewicz
authors.forename: David
authors.initials: D
authors.lastname: Westerman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D014740:Vidarabine; C024352:fludarabine