title: Therapy-Related Myeloid Neoplasms.
abstract: OBJECTIVE
  In the 2008 World Health Organization classification, cases of acute myeloid leukemia (AML) and myelodysplastic syndrome that arise after chemotherapy or radiation therapy for a primary neoplasm are considered together as therapy-related myeloid neoplasms (TR-MNs). This concept, however, is not universally accepted since there are confounding variables in attributing myeloid neoplasms to earlier therapies.
  
  
  METHODS
  Cases in session 6 of the 2013 Workshop of the Society for Hematopathology/European Association for Haematopathology illustrated myeloid neoplasms thought likely to be TR-MNs, and discussed the differences and biologic similarities with de novo myeloid neoplasms.
  
  
  RESULTS
  We reviewed data showing that diagnosis of TR-MN alters patient outcome only in specific subsets. The session also included examples of therapy-related AML with recurrent genetic abnormalities, such as t(15;17), inv(16), and t(8;21), and reports were highlighted showing that patients with these neoplasms have clinical outcomes similar to patients with their de novo counterparts.
  
  
  CONCLUSIONS
  The study of TR-MNs will likely provide insight into the pathogenesis of de novo myeloid disease and may explain why some patients with cancer develop TR-MN and evidently have a higher genetic susceptibility, whereas most patients treated with the same agents do not. These studies will also result in critical reappraisal of current concepts related to TR-MNs.
authors.affiliation: From the Division of Pathology and Laboratory Medicine, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, and cbuesora@mdanderson.org cahanson@mayo.edu.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Bueso-Ramos
authors.affiliation: From the Division of Pathology and Laboratory Medicine, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, and.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kanagal-Shamanna
authors.affiliation: From the Division of Pathology and Laboratory Medicine, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, and.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Routbort
authors.affiliation: The Division of Hematopathology, Mayo Clinic, Rochester, MN. cbuesora@mdanderson.org cahanson@mayo.edu.
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Hanson
mesh_terms: D006801:Humans; D009196:Myeloproliferative Disorders / Q000209:etiology* / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000473:pathology*
keywords: Ionizing radiation therapy; Therapy-related acute myeloid leukemia; Therapy-related myelodysplastic syndrome; Therapy-related myeloid neoplasms; Topoisomerase II inhibitors; alkylating agents