title: Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer.
abstract: BACKGROUND
  Therapy-related acute myeloid leukemia (t-AML) associated with radioiodine treatment (RAI) is emerging as an important clinical entity with the rise in incidence of thyroid cancer.
  
  
  METHODS
  We conducted an electronic search of MEDLINE and EMBASE, and also searched reference lists of articles and abstracts from conference proceedings for case reports and review articles on t-AML following radioiodine therapy. A total of 37 patients with acute myeloid neoplasms following radioiodine treatment were analyzed.
  
  
  RESULTS
  The median RAI dose was 324 mCi, and median age was 47.5 years with M/F ratio of 1:3. Latency period was 1-4 years, and the median time from RAI exposure to diagnosis of t-AML was 2.9 years. FAB M2 and M3 were the two most common t-AML subtypes reported. Seventy-one percent of the cases that reported cytogenetic abnormalities were classified as unfavorable. The most commonly reported abnormalities were del 5q and t(15:17). Survival outcomes were not reported due to lack of patient-level data.
  
  
  CONCLUSIONS
  T-AML following radioiodine therapy for thyroid cancer appears to have a shorter latency period than other types of t-AML, which is an important consideration for post-therapy surveillance. Reporting of cases and outcomes will help provide data for further research. Identifying biomarkers that help risk-stratify patients prior to therapy and specific genetic-guided therapies may help improve outcomes.
authors.affiliation: Department of Medicine, Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA, 19611, USA. tokunbo_sade@yahoo.com.
authors.forename: Adetokunbo
authors.initials: A
authors.lastname: Oluwasanjo
authors.affiliation: Department of Medicine, Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA, 19611, USA.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Pathak
authors.affiliation: Department of Medicine, Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA, 19611, USA.
authors.forename: Anene
authors.initials: A
authors.lastname: Ukaigwe
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, 1365C Clifton Road NE, Suite 5010, Atlanta, GA, 30322, USA.
authors.forename: Olatunji
authors.initials: O
authors.lastname: Alese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000532:radiotherapy*; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes
keywords: Acute; Leukemia; Myeloid; Radiation-induced; Radioisotopes; Thyroid neoplasms