title: Therapy-related myelodysplastic syndrome and acute myeloid leukemia in patients with chronic lymphocytic leukemia treated with fludarabine and cyclophosphamide.
abstract: We retrospectively studied four cases of t-MDS/AML among 210 (1.9%) consecutive patients with CLL treated at a single center with fludarabine and cyclophosphamide (FC) either as the first- or second-line therapy. The median follow-up of the whole cohort of patients was 46months (range: 7-60). Two of these patients (2/130, 1.7%) had been treated with FC only, and two more (2/80, 2.3%) with CHOP and CHOP+FND, respectively, prior to FC. The median age was 61.5years (range: 49-71); three were male. They developed t-MDS/AML after a median latency period of 41months (range: 7-56) from the FC completion. Chromosomal aberrations with an adverse prognostic impact were present in the karyotype of all four patients, including abnormalities of chromosome 5 in three of them, and a rare chromosomal translocation in one patient. Median survival after t-MDS/AML diagnosis was 4months (range: 2-8). Although the agents administered prior to FC make it difficult to assess the risk of t-MDS/AML attributable to FC, this report might be a valuable addition to the literature.
authors.affiliation: Medical Faculty, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia. marcolov@sbb.rs
authors.forename: M
authors.initials: M
authors.lastname: Colović
authors.forename: N
authors.initials: N
authors.lastname: Suvajdžić
authors.forename: G
authors.initials: G
authors.lastname: Janković
authors.forename: D
authors.initials: D
authors.lastname: Tomin
authors.forename: N
authors.initials: N
authors.lastname: Colović
authors.forename: M Denčić
authors.initials: MD
authors.lastname: Fekete
authors.forename: V
authors.initials: V
authors.lastname: Palibrk
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002895:Chromosomes, Human, Pair 5 / Q000187:drug effects; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000235:genetics; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000235:genetics; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000235:genetics; D011379:Prognosis; D012189:Retrospective Studies; D014178:Translocation, Genetic / Q000187:drug effects; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine