Therapy-related myeloid leukemia.
Therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/t-AML) are thought to be the direct consequence of mutational events induced by chemotherapy, radiation therapy, immunosuppressive therapy, or a combination of these modalities, given for a pre-existing condition. The outcomes for these patients have been poor historically compared to people who develop de novo AML. The spectrum of cytogenetic abnormalities in t-AML is similar to de novo AML, but the frequency of unfavorable cytogenetics, such as a complex karyotype or deletion or loss of chromosomes 5 and/or 7, is considerably higher in t-AML. Survival varies according to cytogenetic risk group in t-AML patients, with better outcomes being observed in those with favorable-risk karyotypes. Treatment recommendations should be based on performance status and karyotype. A deeper understanding of the factors that predispose patients to the development of therapy-related myeloid leukemia would help clinicians monitor patients more carefully after treatment for a primary condition. Ultimately, this knowledge could influence initial treatment strategies with the goal of decreasing the incidence of this serious complication.
Godley
Lucy A
LA
Department of Medicine and Cancer Research Center, University of Chicago, Chicago, IL 60637, USA. lgodley@medicine.bsd.uchicago.edu <lgodley@medicine.bsd.uchicago.edu>
Larson
Richard A
RA
D000970:Antineoplastic Agents / Q000009:adverse effects; D002869:Chromosome Aberrations; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology*; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D014178:Translocation, Genetic; D016896:Treatment Outcome
D000970:Antineoplastic Agents