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Sperotto A, Stanghellini MTL, Peccatori J, De Marchi R, Piemontese S, Ciotti G, Basso M, Pierdomenico E, Fiore P, Ciceri F, Gottardi M. CPX-351 and allogeneic stem cell transplant for a therapy-related acute myeloid leukemia that developed after treatment of acute promyelocytic leukemia: a case report and review of the literature. Front Oncol 2024; 13:1291457. [PMID: 38333543 PMCID: PMC10850225 DOI: 10.3389/fonc.2023.1291457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/28/2023] [Indexed: 02/10/2024] Open
Abstract
Therapy-related myeloid neoplasms (t-MNs), which develop after cytotoxic, radiation, or immunosuppressive therapy for an unrelated disease, account for 7%-8% of acute myeloid leukemia (AML). Worse outcomes and consequently shortened survival are associated with t-MNs as compared with de novo AML. Therapy-related MNs are being reported with increasing frequency in successfully treated acute promyelocytic leukemia (APL), in particular, before the introduction of all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO). Considering the high curability of APL, t-MNs represent one of the prognosis-limiting factors in this setting of leukemia. We report our experience with a patient who developed t-AML 15 years after treatment for APL. Treatment included three cycles of chemotherapy with CPX-351 (Vyxeos, Jazz Pharmaceuticals) followed, as in remission, by an allogeneic hematopoietic stem cell transplant. A review of available literature was also included.
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Affiliation(s)
- Alessandra Sperotto
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
| | - Maria Teresa Lupo Stanghellini
- Hematology and Hematopoietic Stem Cell Transplantation Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Jacopo Peccatori
- Hematology and Hematopoietic Stem Cell Transplantation Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Roberta De Marchi
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
| | - Simona Piemontese
- Hematology and Hematopoietic Stem Cell Transplantation Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Giulia Ciotti
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
| | - Marco Basso
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
| | - Elisabetta Pierdomenico
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
| | - Paolo Fiore
- Hematology and Hematopoietic Stem Cell Transplantation Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Fabio Ciceri
- Hematology and Hematopoietic Stem Cell Transplantation Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy
| | - Michele Gottardi
- Onco Hematology, Department of Oncology, Veneto Institute of Oncology, Istituto Oncologico Veneto-Istituto di Ricerca e Cura a Carattere Scientifico (IOV-IRCCS), Castelfranco Veneto, Italy
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2
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Fu S, Li M, Wang H. BCR-ABL1-positive acute lymphoblastic leukemia following successful treatment of acute promyelocytic leukemia: case report. Front Pharmacol 2023; 14:1141311. [PMID: 37397496 PMCID: PMC10311545 DOI: 10.3389/fphar.2023.1141311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Acute promyelocytic leukemia (APL) is currently considered a disease with a higher cure rate. And cases of secondary malignant tumors following successful APL treatment are rare. Here we described a rare case of a 29-year-old man who was treated for APL in 2019 and developed BCR-ABL1-positive acute lymphoblastic leukemia 2 years later. The patient responded well to tyrosine kinase inhibitors and chemotherapy, and achieved a molecular remission. Although APL usually has a good prognosis, the prognosis of its secondary malignancies is uncertain. There are no effective measures to prevent the occurrence of secondary tumors. Continuing to increase the monitoring frequency of laboratory tests, especially the molecular biomarkers, is essential for the diagnosis and treatment of secondary malignancies after the patients achieving complete remission.
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Affiliation(s)
- Shuang Fu
- Department of Hematology Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengqi Li
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hongtao Wang
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
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3
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Wang Z, Xu MZ, Chen YF, Xue F, Zhang L, Hu YM, Li CW, Li SZ, Wang JX, Mi YC. [Therapy-related myeloid neoplasms after successful treatment for acute promyelocytic leukemia: a report of four cases and literature review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:1008-1014. [PMID: 32023731 PMCID: PMC7342672 DOI: 10.3760/cma.j.issn.0253-2727.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Indexed: 12/05/2022]
Abstract
Objective: To investigate the clinical characteristics, diagnosis, treatment and prognosis of therapy-related myeloid neoplasms (t-MNs) after successful treatment for acute promyelocytic leukemia (APL) . Methods: Clinical data of 4 patients, diagnosed as t-MNs secondary to APL at Hematology Hospital of Chinese Academy of Medical Sciences from October 2012 to January 2019, were collected retrospectively. T-MNs related literature was reviewed. Results: The 4 cases were all females, with the median age 42 (range 40-53) years old at the diagnosis of APL. Regarding the induction and consolidation regimens, 3 patients received all-trans retinoid acid (ATRA) and arsenic trioxide (ATO) combined with anthracycline/anthraquinone and/or cytosine. One patient only received ATRA and other auxiliary drugs. Alkylating agents were not administrated. The 4 patients developed t-MNs 40 to 43 months after complete remission (CR) of APL, including 1 case of therapy-related myelodysplastic syndrome (t-MDS) and 3 cases of acute myeloid leukemia (t-AML) . The PML-RARα fusion genes were all negative when t-MNs developed. The three patients with t-AML were treated with 3 to 4 re-induction regimens, one of whom underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after complete remission (CR) . One patient with t-MDS received hypomethylating agents. After a median follow-up of 54.5 (48-62) months, 2 patients with t-AML died, the median overall survival after t-MN was 12 (5-18) months. From 1989 to 2018, a total of 63 t-MN cases were reported in the literature. Therefore, 67 cases were analyzed when four patients in our center were added, including 27 males and 40 females with median age 52.5 (15-76) years. The median latency was 39 (12-126) months and the median overall survival after diagnosis of t-MN was 10 (1-39) months. Conclusions: Although rare, t-MNs may occur after successful control of APL. There are no existing guidelines for prevention and treatment of t-MNs, which have very poor prognosis. If cytopenia or other abnormalities of peripheral blood cells develop after 3 years of APL, t-MNs should be considered as a differential diagnosis.
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Affiliation(s)
- Z Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - M Z Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y F Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - F Xue
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - L Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y M Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - C W Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - S Z Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - J X Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
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Gaut D, Sasine J, Schiller G. Secondary clonal hematologic neoplasia following successful therapy for acute promyelocytic leukemia (APL): A report of two cases and review of the literature. Leuk Res Rep 2018; 9:65-71. [PMID: 29892552 PMCID: PMC5993360 DOI: 10.1016/j.lrr.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/16/2018] [Accepted: 04/07/2018] [Indexed: 11/27/2022] Open
Abstract
Although rare, secondary clonal hematologic neoplasia may occur after successful therapy for acute promyelocytic leukemia (APL). These secondary clonal events may be considered therapy-related, but may also be due to an underlying background of clonal hematopoiesis from which both malignancies may develop. In this manuscript, we describe two patients with secondary clones after APL therapy characterized in one patient by deletion of chromosome 11q23 and, in the other, by monosomy of chromosome 7, and also provide a review of all secondary clonal disorders described after APL therapy. We suggest that since most reports identify karyotypic abnormalities not typically associated with chemotherapy, there may be another mechanism underlying secondary clonal development after complete response to initial APL therapy.
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Key Words
- 6-MP, 6-mercaptopurine
- AML, acute myelocytic leukemia
- APL, acute promyelocytic leukemia
- ATG, antithymyocyte globulin
- ATO, arsenic trioxide
- ATRA, all-trans retinoic acid
- Acute myelocytic leukemia (AML)
- CR, complete remission
- FISH, fluorescence in situ hybridization
- MDS, myelodysplastic syndrome
- Myelodysplastic syndrome (MDS)
- PML-RARalpha, promyelocytic leukemia/Retinoic acid receptor alpha
- Secondary clone
- Therapy-related acute myelocytic leukemia (t-AML)
- Therapy-related myelodysplastic syndrome (t-MDS)
- t- MDS, therapy-related myelodysplastic syndrome
- t-AML, therapy-related acute myelocytic leukemia
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Affiliation(s)
- Daria Gaut
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
| | - Joshua Sasine
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
| | - Gary Schiller
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
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5
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Therapy-related acute myeloid leukemia after successful therapy for acute promyelocytic leukemia with t(15;17): A case report and literature review. Leuk Res 2009; 33:e64-8. [PMID: 19297021 DOI: 10.1016/j.leukres.2009.01.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 01/21/2009] [Accepted: 01/24/2009] [Indexed: 01/06/2023]
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6
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Park TS, Choi JR, Yoon SH, Song J, Kim J, Kim SJ, Kwon O, Min YH. Acute promyelocytic leukemia relapsing as secondary acute myelogenous leukemia with translocation t(3;21)(q26;q22) and RUNX1–MDS1–EVI1 fusion transcript. ACTA ACUST UNITED AC 2008; 187:61-73. [DOI: 10.1016/j.cancergencyto.2008.06.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 06/22/2008] [Accepted: 06/30/2008] [Indexed: 11/30/2022]
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7
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Pawarode A, Finlay E, Sait SNJ, Barcos M, Baer MR. Isochromosome 1q in a myelodysplastic syndrome after treatment for acute promyelocytic leukemia. ACTA ACUST UNITED AC 2006; 167:155-60. [PMID: 16737916 DOI: 10.1016/j.cancergencyto.2005.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 11/23/2005] [Accepted: 11/29/2005] [Indexed: 12/26/2022]
Abstract
A growing body of literature reports therapy-related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) in patients treated successfully for acute promyelocytic leukemia (APL). We report a t-MDS with an isochromosome 1q as a sole abnormality, 47,XY,+1,i(1)(q10), in a 46-year-old man with APL 14 years after he was treated with cytosine arabinosine and daunorubicin. The literature on t-MDS/t-AML after APL therapy and on isochromosome 1q is reviewed.
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Affiliation(s)
- Attaphol Pawarode
- Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
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8
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Tallman MS, Rowe JM. Long-term follow-up and potential for cure in acute promyelocytic leukaemia. Best Pract Res Clin Haematol 2003; 16:535-43. [PMID: 12935968 DOI: 10.1016/s1521-6926(03)00058-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Acute promyelocytic leukaemia (APL) may be characterized simultaneously as the most potentially rapidly fatal human acute leukaemia if untreated, yet the most frequently cured acute leukaemia if promptly diagnosed and treated without delay. Co-operative group and single-institution studies which include large numbers of patients with relatively long follow-up demonstrate that, with all-trans retinoic acid (ATRA) plus anthracycline-based chemotherapy, the majority of newly-diagnosed patients appear cured of their disease. The 5-year disease-free survival rates range from 75 to 85%. Early death is still observed in approximately 10% of patients and remains a difficult obstacle to increasing the cure rate. Prognostic factors which identify patients at high risk for recurrence are becoming increasingly recognized. Older age (over age 55-60 years), elevated white blood cell count at presentation (higher than 5,000-10,000/microl), and expression of CD56 unfavourably influence outcome. The treatment of such patients remains a challenge, although it is important to note that APL is the only type of AML in which a significant proportion of older patients may be cured. Because more patients are cured of their disease, potential long-term consequences may become increasingly recognized. These include the emergence of extramedullary disease, the development of secondary myelodysplasia or acute myeloid leukaemia and the potential for late-onset cardiac toxicity.
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Affiliation(s)
- Martin S Tallman
- Division of Hematology/Oncology, School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg, 676 N. St Clair, Suite 850, Chicago, IL 60611, USA.
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9
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Lobe I, Rigal-Huguet F, Vekhoff A, Desablens B, Bordessoule D, Mounier C, Ferrant A, Sanz M, Fey M, Chomienne C, Chevret S, Degos L, Fenaux P. Myelodysplastic syndrome after acute promyelocytic leukemia: the European APL group experience. Leukemia 2003; 17:1600-4. [PMID: 12886249 DOI: 10.1038/sj.leu.2403034] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With improved treatment of acute promyelocytic leukemia (APL) by all trans retinoic acid (ATRA) combined to anthracycline-aracytin chemotherapy (CT), a larger number of those patients may be at risk of late complications. Recently, the Rome group reported five cases of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML, non-APL) occurring during the course of 77 APL patients (6.5%) in complete remission (CR). From 1991 to 1998, we treated 677 newly diagnosed cases of APL, and 617 of them achieved CR with ATRA combined to CT (n=579) or CT alone (n=38); 246 of them received subsequent maintenance CT with 6 mercaptopurine and methotrexate. With a median follow-up of 51 months, 6 patients (0.97%) developed MDS, 13-74 months after the diagnosis of APL. In all six cases, t(15;17) and PML-RARalpha rearrangement were absent at the time of MDS diagnosis, and karyotype mainly showed complex cytogenetic abnormalities involving chromosomes 5 and/or 7, typical of MDS observed after treatment with alkylating agents, although none of the six patients had received such agents for the treatment of APL. Our findings suggest that MDS can indeed be a long-term complication in APL, although probably at lower incidence than that previously reported.
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Affiliation(s)
- I Lobe
- Service des Maladies du Sang, CHU Lille, France
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10
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Zompi S, Viguié F. Therapy-related acute myeloid leukemia and myelodysplasia after successful treatment of acute promyelocytic leukemia. Leuk Lymphoma 2002; 43:275-80. [PMID: 11999558 DOI: 10.1080/10428190290006044] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The incidence of therapy-related myelodysplasia (t-MDS) and therapy-related acute myeloid leukemia (t-AML). following a high-dose chemotherapy for a prior cancer, is progressively increasing. Here we review patients treated by conventional therapy for acute promyelocytic leukemia (APL) who developed a t-MDS or t-AML in the course of their disease. This risk appears to be low, as only 12 unquestionable cases have been reported so far in the literature. Alkylating agents and etoposide are two major agents able to induce t-MDS or t-AML. However, some cases ask the question of the leukemic potential of other drugs, especially anthracyclines. The median latent period from achievement of complete remission (CR) of APL to diagnosis of t-MDS or t-AML was 34 (25-40) months. All patients presented chromosome abnormalities, mostly deletions or loss of the long arm of chromosome 5 and/or 7, or balanced translocations involving the 21q22 band. Prognosis is poor with a median of survival of 10 (7-22) months.
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Affiliation(s)
- Simona Zompi
- Service d'Hématologie Biologique, Hôpital Hôtel-Dieu, Paris, France
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11
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Latagliata R, Petti MC, Fenu S, Mancini M, Spiriti MAA, Breccia M, Brunetti GA, Avvisati G, Lo Coco F, Mandelli F. Therapy-related myelodysplastic syndrome-acute myelogenous leukemia in patients treated for acute promyelocytic leukemia: an emerging problem. Blood 2002; 99:822-4. [PMID: 11806982 DOI: 10.1182/blood.v99.3.822] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The use of all-trans retinoic acid (ATRA) in combination with chemotherapy has markedly improved the prognosis for patients with acute promyelocytic leukemia (APL); the higher complete remission (CR) and survival rates now reported in this disease almost approach those obtained for other highly curable hematologic malignancies. Of 77 patients with APL who were consecutively treated at a single institution and who achieved CR after induction and consolidation therapy, 5 (6.5%) acquired therapy-related myelodysplasia (tMDS), acute myelogenous leukemia (AML), or both (tMDS-AML). Of these, 3 of 46 (6.5%) patients received front-line chemotherapy with or without ATRA and acquired tMDS-AML while in first remission of APL. Two underwent repeated chemotherapy cycles with ATRA because of APL relapse and acquired tMDS-AML while in the second or third remission of APL. In 2 patients, clinical and biologic characteristics of tMDS-AML were as expected for postalkylating forms (long latency, MDS phase preceding AML, karyotypic aberrations involving chromosomes 5 or 7), even though one of them had not previously received alkylating drugs. Three of the 5 patients died shortly after tMDS-AML diagnosis, one is alive with tMDS, and one is alive and in CR after allogeneic bone marrow transplantation. The occurrence of tMDS-AML after successful therapy for APL is an emerging problem. The availability of prognostic score systems at initial diagnosis and monitoring of residual disease by polymerase chain reaction might allow better tailoring of treatment intensity in APL to spare unnecessary toxicity and to minimize the risk for tMDS-AML in patients who are presumably cured.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Cytogenetic Analysis
- Female
- Follow-Up Studies
- Humans
- Leukemia, Myeloid, Acute/chemically induced
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Promyelocytic, Acute/drug therapy
- Male
- Myelodysplastic Syndromes/chemically induced
- Myelodysplastic Syndromes/diagnosis
- Myelodysplastic Syndromes/mortality
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/mortality
- Treatment Outcome
- Tretinoin/administration & dosage
- Tretinoin/adverse effects
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Affiliation(s)
- Roberto Latagliata
- Department of Human Biotechnologies and Hematology, University La Sapienza of Rome, Cattedra di Ematologia, Via Benevento 6-00161, Rome, Italy.
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12
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Zompi S, Legrand O, Bouscary D, Blanc CM, Picard F, Casadevall N, Dreyfus F, Marie JP, Viguié F. Therapy-related acute myeloid leukaemia after successful therapy for acute promyelocytic leukaemia with t(15;17): a report of two cases and a review of the literature. Br J Haematol 2000; 110:610-3. [PMID: 10997972 DOI: 10.1046/j.1365-2141.2000.02240.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe two patients with positive t(15;17) acute promyelocytic leukaemia (APL) that developed into a therapy-related myelodysplasia 2-2.5 years after complete remission (CR) and then evolved into therapy-related acute myeloid leukaemia (t-AML). Both patients received anthracyclines as potential leukaemogenic drugs. In both cases, cytogenetic changes usually occurring after use of alkylating agents were noticed: monosomy 7 associated with monosomy 5 or 5q- chromosome. A review of the literature on t-AML occurring after successful therapy for APL showed only one report similar to these two cases. These observations suggest that anthracyclines can cause t-AML similar to that induced by alkylating agents.
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MESH Headings
- Adult
- Antibiotics, Antineoplastic/adverse effects
- Antibiotics, Antineoplastic/therapeutic use
- Child
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 7
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/genetics
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Middle Aged
- Monosomy
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- S Zompi
- Services d'Hématologie biologique et clinique, Hôpital Hôtel-Dieu, and Services d'Hématologie biologique et clinique, Hôpital Cochin, Paris, France
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