title: Myeloid neoplasms after breast cancer: "therapy-related" not an independent poor prognostic factor.
abstract: Two hundred and thirty-five consecutive patients presenting to a single center with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) after breast cancer treatment were compared with matched patients with de novo AML or MDS. There was no significant difference in median overall survival (OS) times between patients with therapy-related AML and those with de novo AML (8.7 months vs.10.2 months; p = 0.17). Patients with therapy-related MDS had slightly lower median baseline platelet counts and a higher frequency of poor cytogenetics than those with de novo MDS, but the two groups had similar OS times (13.6 months vs. 18.9 months; p = 0.06). Multivariate analysis revealed that cytogenetic risk, baseline white blood cell count, age and performance status were predictive for OS time in AML and that cytogenetic risk and performance status were predictive for OS time in MDS. Having therapy-related disease is not an independent risk factor in patients with myeloid neoplasms and with a history of breast cancer. Clinical trials should be designed to serve both populations.
authors.affiliation: Department of Leukemia, The University of Texas M. D. Anderson Cancer Center , Houston, TX.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Chen
authors.forename: Zeev
authors.initials: Z
authors.lastname: Estrov
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Wei
authors.initials: W
authors.lastname: Qiao
authors.forename: Gautam
authors.initials: G
authors.lastname: Borthakur
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Tapan
authors.initials: T
authors.lastname: Kadia
authors.forename: Mark
authors.initials: M
authors.lastname: Brandt
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000209:etiology; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*
keywords: Myeloid leukemias and dysplasias; chemotherapeutic approaches; prognostication