Acute leukaemia following malignant ependymoma: A case report

Pai, M. R. S. M.; Advani, Suresh H.; Ramakrishnan, G.; Nair, Chandrika N.; Tk, Saikia; Kamat, Deepak

doi:10.1002/jso.2930290102

Cited by 7 publications

(1 citation statement)

References 19 publications

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“…t-MDS/ t-AML has also been described in individuals exposed to radiation only. 22,30,31 For example, Detourmignies et al described a 12-year-old boy who developed acute promyelocytic leukemia after radiation for cerebral astrocytoma. 32 Risk may be correlated to the volume of exposed marrow.…”

Section: Radiation Therapymentioning

confidence: 99%

Treatment-related myelodysplasia in patients with primary brain tumors

Baehring

Marks²

2012

Neuro-Oncology

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Treatment-related myelodysplastic syndrome (t-MDS) and treatment-related acute myelogenous leukemia (t-AML) represent rare secondary events in patients with primary tumors of the nervous system and predominantly affect those treated with alkylating agents or topoisomerase II inhibitors. Temozolomide has become the standard chemotherapeutic agent for malignant gliomas. The emergence of this alkylating agent with little acute toxicity or cumulative myelosuppression has led to off-label protracted chemotherapy for many patients with malignant and even low-grade infiltrative gliomas, raising concern for increased risk of t-MDS/ t-AML in the few long-term survivors. On the basis of an extensive literature search, we provide a discussion of epidemiology, pathogenesis, clinical presentation, diagnosis, and therapy of these disorders. t-MDS/ t-AML remain rare complications of chemotherapy in patients with primary brain tumors, and the vast majority of patients die of their primary neoplasm. Prospective randomized studies with long-term follow-up are required to accurately assess the risk of t-MDS/t-AML; however, unless survival in the most common gliomas substantially increases, t-MDS/t-AML incidence will likely remain low in this patient population.

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Section: Radiation Therapymentioning

confidence: 99%

Treatment-related myelodysplasia in patients with primary brain tumors

Baehring

Marks²

2012

Neuro-Oncology

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Global characteristics of childhood acute promyelocytic leukemia

et al. 2015

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Acute promyelocytic leukemia (APL) comprises approximately 5–10% of childhood acute myeloid leukemia (AML) cases in the US. While variation in this percentage among other populations was noted previously, global patterns of childhood APL have not been thoroughly characterized. In this comprehensive review of childhood APL, we examined its geographic pattern and the potential contribution of environmental factors to observed variation. In 142 studies (spanning >60 countries) identified, variation was apparent—de novo APL represented from 2% (Switzerland) to >50% (Nicaragua) of childhood AML in different geographic regions. Because a limited number of previous studies addressed specific environmental exposures that potentially underlie childhood APL development, we gathered 28 childhood cases of therapy-related APL, which exemplified associations between prior exposures to chemotherapeutic drugs/radiation and APL diagnosis. Future population-based studies examining childhood APL patterns and the potential association with specific environmental exposures and other risk factors are needed.

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Perry

Brown

Gockerman

1998

Journal of Neuro-Oncology

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We report two patients with acute myeloid leukemia (AML) following therapy for malignant glioma; one was a young women treated heavily with alkylating agents for glioblastoma and the other a young man treated with high doses of procarbazine, lomustine, and vincristine (PCV) for anaplastic astrocytoma. We found 26 other examples of therapy related leukemia in adult and pediatric brain tumor patients. Including our two, there were 12 patients with malignant glioma; median interval from treatment to diagnosis of AML was 31 months. Nine adult malignant glioma patients all received nitrosoureas, some as the sole form of chemotherapy. No definite cases occurred after radiotherapy alone. Based upon analogy with other cancers, the cumulative dose of chemotherapy, especially alkylating agents, is the major risk factor for development of secondary AML. Agents implicated include carmustine (BCNU), lomustine (CCNU), and procarbazine. Conventional radiotherapy appears not to confer additional risk. Progressive macrocytosis, early dose reductions for thrombocytopenia, and refractory anemia may provide early diagnostic clues. Current glioma therapy is leukemogenic but the number of patients who survive the interval required to induce AML is small; nevertheless, the identification of chemosensitive types of glioma, and subgroups of patients who derive the most benefit from chemotherapy, may result in increasing numbers of patients at risk of long term complications. If regimens such as PCV continue to prove valuable in neurooncology the risk of leukemia will require integration into the clinical decision process. A search for more effective therapy with minimal mutagenicity remains critical.

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Acute leukaemia following malignant ependymoma: A case report

Cited by 7 publications

References 19 publications

Treatment-related myelodysplasia in patients with primary brain tumors

Treatment-related myelodysplasia in patients with primary brain tumors

Global characteristics of childhood acute promyelocytic leukemia

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