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Title: Therapy-related acute myeloid leukemia and myelodysplastic syndrome: a clinical and morphologic study of 65 cases

This study consists of 65 patients (pts) who developed a myelodysplastic syndrome (MDS) (39 pts) or acute myeloid leukemia (AML) (26 pts) following chemotherapy and/or radiotherapy; the interval from the onset of therapy to bone marrow abnormality ranged from 11 to 192 months (median, 58). Thirty-three patients had been previously treated for lymphoproliferative diseases, 29 for carcinoma, and three for a nonneoplastic disorder. Approximately 30% of the cases presenting in the MDS phase evolved to AML in one to 12 months (median, 3.5). The AML in 49% of the cases was not readily classified according to French-American-British (FAB) criteria; the primary difficulty in classification related to the involvement of multiple cell lines. Among the cases that could be classified, all FAB types were represented except for M1; M2 was the most frequent type. Clonal chromosome abnormalities were found in marrow specimens from 22 of 24 (92%) patients studied with G banding; 11 had abnormalities of chromosomes 5 and/or 7. The median survival for all patients was four months with no significant difference between those treated and not treated with antileukemic therapy. The median survival was three months for the patients presenting with AML, six months for the patients with AMLmore » following an MDS, and four months for the patients with an MDS that did not evolve to AML. The findings in the present study suggest that there are three stages of therapy-related panmyelosis: (1) pancytopenia with associated myelodysplastic changes, (2) a frank MDS, and (3) overt AML. Many patients will present in the stage of overt AML that differs from de novo AML primarily by the high incidence of trilineage involvement, difficulty in classification, frequent cytogenetic abnormalities, and poor response to antileukemic therapy.« less
Authors:
; ; ;
Publication Date:
OSTI Identifier:
5021579
Resource Type:
Journal Article
Resource Relation:
Journal Name: Blood; (United States); Journal Volume: 6
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MYELOID LEUKEMIA; CHEMOTHERAPY; RADIOTHERAPY; BONE MARROW; CELL PROLIFERATION; CHLORAMBUCIL; CHROMOSOMAL ABERRATIONS; PATIENTS; SURVIVAL TIME; AMINES; ANIMAL TISSUES; ANTINEOPLASTIC DRUGS; BODY; CARBOXYLIC ACIDS; DISEASES; DRUGS; HEMATOPOIETIC SYSTEM; HEMIC DISEASES; LEUKEMIA; MEDICINE; MONOCARBOXYLIC ACIDS; MUTATIONS; NEOPLASMS; NUCLEAR MEDICINE; ORGANIC ACIDS; ORGANIC CHLORINE COMPOUNDS; ORGANIC COMPOUNDS; ORGANIC HALOGEN COMPOUNDS; ORGANS; RADIOLOGY; THERAPY; TISSUES 550602* -- Medicine-- External Radiation in Diagnostics-- (1980-)