| Abstract: |
Therapy-related MDS and AML are complications of intensive chemotherapy regimens. Traditionally, patients exposed to topoisomerase II inhibitors are reported to develop secondary AML with abnormalities of chromosome 11q23. We evaluated the long-term hematologic toxicity of topoisomerase II-intensive high-dose mitoxantrone-based chemotherapy in 163 newly diagnosed acute leukemia patients treated over an 8 year period. Nine (5.5%) patients developed new cytogenetic abnormalities. Four patients developed MDS with progression to AML, three patients developed new abnormalities at the time of relapse, and three patients (including one of the former patients) had changes that were not associated with hematologic disease. The abnormalities most frequently involved chromosomes 7q, 20q, 1q, and 13q. Despite the use of topoisomerase II-intensive treatment, no patient developed an abnormality involving chromosome 11q23. Spontaneous resolution of some changes and prolonged persistence of others in the absence of hematologic disease indicates that some cytogenetic changes are not sufficient to promote leukemogenesis. |
| Keywords: |
adult; cancer chemotherapy; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; leukemia; retrospective studies; acute granulocytic leukemia; major clinical study; prednisone; disease course; cytarabine; methotrexate; drug megadose; etoposide; blood toxicity; antineoplastic combined chemotherapy protocols; incidence; neoplasm proteins; cytogenetics; vincristine; chromosome aberration; acute leukemia; evaluation; randomized controlled trials; enzyme inhibitors; disease progression; leukemogenesis; leukemia, myeloid; mitoxantrone; remission induction; asparaginase; idarubicin; neoplasms, second primary; chromosome aberrations; karyotyping; chromosomes, human, pair 11; chromosome 1q; chromosome 11q; dna topoisomerases, type ii; myelodysplastic syndromes; drug exposure; acute disease; chromosome 20q; chromosome 7q; gyrase inhibitor; mds; chromosome 13q; tretinoin; myelodysplasia; clinical trials, phase ii; clinical trials, phase iii; leukemia, lymphocytic, acute; life tables; humans; human; male; female; priority journal; article; mitoxantone
|
