Secondary hematological malignancies after breast cancer chemotherapy

Park, Myung Joon; Park, Yeon Hee; Ahn, Heui June; Choi, Won Ku; Paik, Kwang Hyun; Kim, Jung Min; Chang, Yoon Hwan; Ryoo, Baek Yeol; Yang, Sung Hyun

doi:10.1080/10428190500125705

Cited by 19 publications

(14 citation statements)

References 8 publications

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“…The most common previous disease was plasma cell myeloma treated with melphalan (21.4%), and there were three patients with follicular lymphoma treated with fludarabine associated with cyclophosphamide, reinforcing the theory that this association increases the risk of developing t-MN as suggested in a previous study 25 . Breast cancer was the most frequent solid tumor (50% – 4/8) consistent with published data that has reported an increased rate of s-MN in this group of survivors probably as a consequence of an effective therapy 26, 27…”

Section: Discussionsupporting

confidence: 89%

Secondary myeloid neoplasms: bone marrow cytogenetic and histological features may be relevant to prognosis

Tanizawa

Zerbini

Rosenfeld

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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BackgroundSecondary myeloid neoplasms comprise a group of diseases arising after chemotherapy, radiation, immunosuppressive therapy or from aplastic anemia. Few studies have addressed prognostic factors in these neoplasms.MethodForty-two patients diagnosed from 1987 to 2008 with secondary myeloid neoplasms were retrospectively evaluated concerning clinical, biochemical, peripheral blood, bone marrow aspirate, biopsy, and immunohistochemistry and cytogenetic features at diagnosis as prognostic factors. The International Prognostic Scoring System was applied. Statistical analysis employed the Kaplan–Meier method, log-rank and Fisher's exact test.ResultsTwenty-three patients (54.8%) were male and the median age was 53.5 years (range: 4–88 years) at diagnosis of secondary myeloid neoplasms. Previous diseases included hematologic malignancies, solid tumors, aplastic anemia, autoimmune diseases and conditions requiring solid organ transplantations. One third of patients (33%) were submitted to chemotherapy alone, 2% to radiotherapy, 26% to both modalities and 28% to immunosuppressive agents. Five patients (11.9%) had undergone autologous hematopoietic stem cell transplantation. The median latency between the primary disease and secondary myeloid neoplasms was 85 months (range: 23–221 months). Eight patients were submitted to allogeneic hematopoietic stem cell transplantation to treat secondary myeloid neoplasms. Important changes in bone marrow were detected mainly by biopsy, immunohistochemistry and cytogenetics. The presence of clusters of CD117+ cells and p53+ cells were associated with low survival. p53 was associated to a higher risk according to the International Prognostic Scoring System. High prevalence of clonal abnormalities (84.3%) and thrombocytopenia (78.6%) were independent factors for poor survival.ConclusionThis study demonstrated that cytogenetics, bone marrow biopsy and immunohistochemistry are very important prognostic tools in secondary myeloid neoplasms.

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Section: Discussionsupporting

confidence: 89%

Secondary myeloid neoplasms: bone marrow cytogenetic and histological features may be relevant to prognosis

Tanizawa

Zerbini

Rosenfeld

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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“…Exposure to radiotherapy may further increase the risk for AML [19-21]. In turn, Smith et al [20] found the M4/M5 subtypes to be more frequent in patients receiving intense treatment regimens and concluded that this could be the result of cyclophosphamide-induced promotion of a doxorubicin-associated leukemogenic effect.…”

Section: Discussionmentioning

confidence: 99%

Acute myeloid leukemia of donor origin after allogeneic stem cell transplantation from a sibling who harbors germline XPD and XRCC3 homozygous polymorphisms

et al. 2011

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A 54-year-old woman was diagnosed with infiltrative ductal breast carcinoma. Two years after treatment, the patient developed an acute myeloid leukemia (AML) which harbored del(11q23) in 8% of the blast cells. The patient was submitted for allogeneic stem cell transplantation (aSCT) from her HLA-compatible sister. Ten months after transplantation, she relapsed with an AML with basophilic maturation characterized by CD45low CD33high, CD117+, CD13-/+, HLA Drhigh, CD123high, and CD203c+ blast cells lacking expression of CD7, CD10, CD34, CD15, CD14, CD56, CD36, CD64, and cytoplasmic tryptase. Karyotype analysis showed the emergence of a new clone with t(2;14) and FISH analysis indicated the presence of MLL gene rearrangement consistent with del(11q23). Interestingly, AML blast cell DNA tested with microsatellite markers showed the same pattern as the donor's, suggesting that this AML emerged from donor cells. Additionally, polymorphisms of the XPA, XPD, XRCC1, XRCC3 and RAD51 DNA repair genes revealed three unfavorable alleles with low DNA repair capacity.In summary, we report the first case of AML involving XPD and XRCC3 polymorphisms from donor origin following allogeneic stem cell transplantation and highlight the potential need for careful analysis of DNA repair gene polymorphisms in selecting candidate donors prior to allogeneic stem cell transplantation.

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“…After treatment of a malignancy with systemic chemotherapy, it is estimated that the 10‐year incidence of AML or MDS is approximately 1.5% 1–3 . The cumulative risk increases by 0.25–1.00% for the first 8 years after treatment 1,2 . Between 10–20% of all new cases of AML and MDS diagnosed each year are considered secondary to a chemotherapy regimen 2,4 .…”

Section: Therapy‐induced Leukaemiamentioning

confidence: 99%

“…Between 10–20% of all new cases of AML and MDS diagnosed each year are considered secondary to a chemotherapy regimen 2,4 . Several chemotherapeutic agents including, but not limited to, the alkylating agents, topoisomerase inhibitors, and taxanes have been associated with the development of AML/MDS 1,2,4–9 (Table 1). The leukaemias associated with use of the alkylating agents and the type II topoisomerase inhibitors have been extensively studied and show several important differences in their presentation 1,2,5–7 (Table 2).…”

Section: Therapy‐induced Leukaemiamentioning

confidence: 99%

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Therapy‐related leukaemia cutis: A review

et al. 2008

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Leukaemia cutis following chemotherapy for a malignancy is a multifactorial process that is dependent on the chemotherapeutic agent used, the dosing regimen, and the cumulative dose as well as potential contributing therapies such as radiation and possibly even hematopoietic support from granulocyte colony stimulating factor. In the right combination and in a patient with a conducive milieu of epigenetic factors, leukaemia can develop as a treatment complication. Leukaemia cutis is the specific infiltration of the skin by leukaemic cells and occurs most commonly when the underlying leukaemia is an acute myeloid leukaemia. Although it is well reviewed in the literature as a result of primary leukaemia, leukaemia cutis has only very rarely been reported in association with therapy-induced leukaemia. This article reviews the factors that contribute to therapy-related leukaemia and the development of leukaemia cutis.

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Secondary hematological malignancies after breast cancer chemotherapy

Cited by 19 publications

References 8 publications

Secondary myeloid neoplasms: bone marrow cytogenetic and histological features may be relevant to prognosis

Secondary myeloid neoplasms: bone marrow cytogenetic and histological features may be relevant to prognosis

Acute myeloid leukemia of donor origin after allogeneic stem cell transplantation from a sibling who harbors germline XPD and XRCC3 homozygous polymorphisms

Therapy‐related leukaemia cutis: A review

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