Routine clinical parameters and laboratory testing predict therapy-related myeloid neoplasms after treatment for breast cancer Journal Article
| Authors: | Petrone, G.; Gaulin, C.; Derkach, A.; Kishtagari, A.; Robson, M. E.; Parameswaran, R.; Stein, E. M. |
| Article Title: | Routine clinical parameters and laboratory testing predict therapy-related myeloid neoplasms after treatment for breast cancer |
| Abstract: | We aim to identify predictors of therapy-related myeloid neoplasms (t-MN) in patients with breast cancer (BC) and cytopenias to determine the timing of bone marrow biopsy (BMBx). Patients with BC and cytopenias who were referred for BMBx between 2002-2018 were identified using the Memorial Sloan Kettering Cancer Center institutional database. Characteristics associated with the risk of t-MN were evaluated by multivariable logistic regression and included in a predictive model. The average area under the receiver operating characteristic curve (AUC) was estimated by 5-fold cross-validation. Of the 206 BC patients who underwent BMBx included in our study, 107 had t-MN. By multivariable analysis, white blood cell count 4-11 K/mcL, absolute neutrophil count (ANC) ≥1.5 K/mcL, hemoglobin ≥12.2 g/dL, red cell distribution width 11.5-14.5%, the presence of bone metastasis and a time from BC diagnosis to BMBx <15 months significantly decreased the likelihood of t-MN. The average AUC was 0.88. We stratified our cohort by bone metastasis and by findings on peripheral smear. In both the subset without bone metastasis (n=159) and in the cohort with no blasts or dysplastic cells on peripheral smear (n=96) our variables had similar effects on the risk of t-MN. Among the 47 patients with bone metastasis, an ANC ≥1.5 K/mcL was the only variable associated with a decreased risk of t-MN. Our findings show that in patients with BC and unexplained cytopenias, clinical and laboratory parameters can predict t-MN and assist clinicians in determining the timing of a BMBx. ©2023 Ferrata Storti Foundation. |
| Keywords: | adult; cancer chemotherapy; controlled study; bone neoplasms; bone tumor; human cell; area under the curve; bone metastasis; follow up; multiple myeloma; breast cancer; anemia; bone marrow; cohort analysis; cytogenetics; alkylating agent; hemoglobin; pathology; breast neoplasms; retrospective study; biopsy; myelodysplastic syndrome; bone marrow biopsy; laboratory test; breast tumor; mean corpuscular volume; blood cell count; leukocyte count; dna topoisomerase (atp hydrolysing); karyotype; cytopenia; leukocyte; roc curve; receiver operating characteristic; parameters; diagnostic test accuracy study; predictive model; humans; human; male; female; article; absolute neutrophil count; cross validation; red blood cell distribution width |
| Journal Title: | Haematologica |
| Volume: | 108 |
| Issue: | 1 |
| ISSN: | 0390-6078 |
| Publisher: | Ferrata Storti Foundation |
| Date Published: | 2023-01-01 |
| Start Page: | 161 |
| End Page: | 170 |
| Language: | English |
| DOI: | 10.3324/haematol.2021.280437 |
| PUBMED: | 35770528 |
| PROVIDER: | scopus |
| PMCID: | PMC9827166 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2023 -- Source: Scopus |
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31Parameswaran -
148Derkach
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