Myeloid neoplasms on poly (ADP-ribose) polymerase inhibitor therapy

Abstract

Poly (ADP-ribose) polymerase inhibitor (PARPi) therapy is progressively accruing more indications. Given their overall survival benefit in many solid organ tumors, they are here to stay. However, an emerging concern is the risk of therapy-related acute myeloid leukemia. A recent meta-analysis has reported a higher risk of myeloid neoplasms while on PARPi therapy. These patients tend to have underlying tumor protein 53 (TP53) mutated clonal hematopoiesis and have complex karyotypes with poor outcomes. Underlying mechanisms and optimal treatment are currently unknown. In this narrative review, we detail the current evidence available on this entity and compare it with the underlying knowledge of therapy-related myeloid neoplasms.