Secondary acute myelogenous leukemia in patients with retinoblastoma: is chemotherapy a factor?
OBJECTIVE
To describe a series of patients with secondary acute myelogenous leukemia (sAML) and retinoblastoma (RB).


METHODS
Retrospective observational cases series.


METHODS
Ocular and pediatric oncologists at referral centers in Europe and the Americas and the RB databases at the National Institutes of Health and the Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center.


METHODS
Physician survey, retrospective database review, and literature search.


METHODS
History of RB and development of sAML, management of RB (surgery, radiotherapy, chemotherapy), age at diagnosis of RB and leukemia, French-American-British (FAB) subtype, and current status of patient (alive or dead).


RESULTS
Fifteen patients with sAML were identified; 13 occurred in childhood. Mean latent period from RB to AML diagnosis was 9.8 years (median, 42 months). Nine cases were of the M2 or M5 FAB subtypes. Twelve patients (79 %) had received chemotherapy with a topoisomerase II inhibitor, 8 (43%) had received chemotherapy with an epipodophyllotoxin. Ten children died of their leukemia.


CONCLUSIONS
Acute myelogenous leukemia is a rare secondary malignancy among retinoblastoma patients, many of whom were treated with primary or adjuvant chemotherapy. Additional studies are needed to assess potential risk factors contributing to sAML development in this cohort.
Gombos
Dan S
DS
Section of Ophthalmology, Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas 77030, USA. dgombos@mdanderson.org
Hungerford
John
J
Abramson
David H
DH
Kingston
Judith
J
Chantada
Guillermo
G
Dunkel
Ira J
IJ
Antoneli
Celia B G
CB
Greenwald
Mark
M
Haik
Barret G
BG
Leal
Carlos A
CA
Medina-Sanson
Aurora
A
Schefler
Amy C
AC
Veerakul
Gavivann
G
Wieland
Regina
R
Bornfeld
Norbert
N
Wilson
Mathew W
MW
Yu
Christopher Bing On
CB
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced*; D008297:Male; D016609:Neoplasms, Second Primary / Q000139:chemically induced*; D011034:Podophyllotoxin / Q000009:adverse effects* / Q000627:therapeutic use; D019572:Retinal Neoplasms / Q000188:drug therapy*; D012175:Retinoblastoma / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D059005:Topoisomerase II Inhibitors
D000972:Antineoplastic Agents, Phytogenic; D004791:Enzyme Inhibitors; D059005:Topoisomerase II Inhibitors; D011034:Podophyllotoxin