Therapy-related acute myeloid leukemia following treatment of lymphoid malignancies
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Sarah Bertoli1,2,3, Arthur Sterin4, Suzanne Tavitian1, Lucie Oberic1, Loïc Ysebaert1,2,3, Reda Bouabdallah4, François Vergez3,5 , Audrey Sarry1, Emilie Bérard6,7, Françoise Huguet1, Guy Laurent1,2, Thomas Prébet4,8, Norbert Vey4,8,9,*, Christian Récher1,2,3,*
1Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
2Université Toulouse III Paul Sabatier, Toulouse, France
3Cancer Research Center of Toulouse (CRCT), UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
4Service d’Hématologie, Institut Paoli-Calmettes, Marseille, France
5Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
6Service d’Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
7UMR 1027, INSERM-Université de Toulouse III, Toulouse, France
8Département d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, UMR1068 Inserm, Marseille, France
9Aix-Marseille University, Marseille, France
Christian Récher, email: [email protected]
Keywords: leukemia, therapy-related acute myeloid leukemia, second cancer, lymphoma, chronic lymphocytic leukemia
Received: May 26, 2016 Accepted: November 01, 2016 Published: November 10, 2016
Therapy-related acute myeloid leukemia (t-AML) is a heterogeneous entity most frequently related to breast cancer or lymphoproliferative diseases (LD). Population-based studies have reported an increased risk of t-AML after treatment of lymphomas. The aim of this study was to describe the characteristics and outcome of 80 consecutive cases of t-AML following treatment of LD. t-AML accounted for 2.3% of all AML cases, occurred 60 months after LD diagnosis, and were characterized by a high frequency of FAB M6 AML and poor-risk cytogenetic abnormalities. Time to t-AML diagnosis was influenced by patient age, type of LD, and treatment. Among the 48 t-AML patients treated with intensive chemotherapy, median overall survival (OS) was 7.7 months compared to 26.1 months in de novo, 4.2 months in post-myeloproliferative neoplasm, 9.4 months in post-myelodysplastic syndrome, 8.6 months in post-chronic myelomonocytic leukemia AML, 13.4 months in t-AML secondary to the treatment of solid cancer, and 14.7 months in breast cancer only. OS of post-LD t-AML patients was significantly influenced by age, performance status, myelodysplastic syndrome prior to LD/t-AML, and treatment regimen for LD. Thus, t-AML following lymphoid malignancies treatment should be considered as very high-risk secondary AML. New treatment strategies in patients with LD/t-AML are needed urgently.
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