Antineoplastics
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Reactions 1259 - 4 Jul 2009 S Antineoplastics Acute myeloid leukaemia: 11 case reports Eleven patients, who developed therapy-related acute myeloid leukaemia (t-AML) following chemotherapy for various cancers, were identified in a retrospective study. [See table for patient characteristics.] The patients were treated for Hodgkin lymphoma (patients 1, 2), anaplastic large cell lymphoma (3), B-cell lymphoma (4, 11), breast cancer (5–8), lung cancer (9) and prostate cancer (10); patients 1, 2 and 7–10 also received radiotherapy. In patient 2, t-AML was preceded by refractory cytopenia and multilineage dysplasia. At the time of t-AML diagnosis, only two patients had active cancer: patient 9 had metastatic disease, and lung cancer had recurred in patient 10. Therapy comprised idarubicin and cytarabine (patients 1, 4, 8, 9), fludarabine and cytarabine (3, 6) or the FLAG regimen * (2, 5, 7); patient 11 was treated with FLAG plus gemtuzumab ozogamicin, and patient 10 received supportive care only. Patients 1–3, 6–9 and 11 achieved full remission, but patient 4 was resistant to treatment, and his therapy was changed to clofarabine/gemtuzumab ozogamicin. Six patients (1–3, 6, 8, 9) experienced t–AML relapse, and patients 1, 3 and 9 underwent bone marrow transplantation. Patients 1–4, 6, 9 and 10 died 2–41 months after t-AML diagnosis. Patients 5, 7 and 11 were alive 36, 7 and 7 months after diagnosis, respectively. Patient characteristics Patient/sex/ Chemotherapy a Time to age (y) onset (m) b 1/M/38 Chlormethine, vincristine, 50 procarbazine, prednisone (MOPP); doxorubicin [Adriamycin], bleomycin, vinblastine, dacarbazine (ABVD) 2/F/68 Doxorubicin, vinblastine, 20 dacarbazine (AVD) 3/M/37 Cyclophosphamide, doxorubicin, 84 vincristine [Oncovin], prednisone (CHOP) 4/M/65 CHOP + rituximab 36 5/F/42 Doxorubicin, cyclophosphamide 36 (AC) + tamoxifen 6/F/74 Cyclophosphamide, doxorubicin, 14 fluorouracil (CAF) + docetaxel 7/F/68 Fluorouracil, epirubicin, 58 cyclophosphamide (FEC); tamoxifen 8/F/50 AC, docetaxel 24 9/F/49 Etoposide, cisplatin 17 10/M/81 Goserelin, docetaxel 156 11/M/58 Cyclophosphamide, vincristine, 27 doxorubicin, dexamethasone (Hyper-CVAD) a dosages and duration of treatments not stated. b time from therapy initiation to t-AML onset. * fludarabine, cytarabine and granulocyte colony-stimulating factor Gustafson SA, et al. Therapy-related acute myeloid leukemia with t(8;21) (q22;q22) shares many features with de novo acute myeloid leukemia with t(8;21)(q22;q22) but does not have a favorable outcome. American Journal of Clinical Pathology 131: 647-655, No. 5, May 2009 - USA 801146275 1 Reactions 4 Jul 2009 No. 1259 0114-9954/10/1259-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1259 - 4 Jul 2009
SAntineoplastics
Acute myeloid leukaemia: 11 case reportsEleven patients, who developed therapy-related acute
myeloid leukaemia (t-AML) following chemotherapy forvarious cancers, were identified in a retrospective study.[See table for patient characteristics.]
The patients were treated for Hodgkin lymphoma(patients 1, 2), anaplastic large cell lymphoma (3), B-celllymphoma (4, 11), breast cancer (5–8), lung cancer (9) andprostate cancer (10); patients 1, 2 and 7–10 also receivedradiotherapy. In patient 2, t-AML was preceded byrefractory cytopenia and multilineage dysplasia. At the timeof t-AML diagnosis, only two patients had active cancer:patient 9 had metastatic disease, and lung cancer hadrecurred in patient 10.
Therapy comprised idarubicin and cytarabine (patients 1,4, 8, 9), fludarabine and cytarabine (3, 6) or the FLAGregimen* (2, 5, 7); patient 11 was treated with FLAG plusgemtuzumab ozogamicin, and patient 10 receivedsupportive care only. Patients 1–3, 6–9 and 11 achieved fullremission, but patient 4 was resistant to treatment, and histherapy was changed to clofarabine/gemtuzumabozogamicin. Six patients (1–3, 6, 8, 9) experienced t–AMLrelapse, and patients 1, 3 and 9 underwent bone marrowtransplantation. Patients 1–4, 6, 9 and 10 died 2–41 monthsafter t-AML diagnosis. Patients 5, 7 and 11 were alive 36, 7and 7 months after diagnosis, respectively.
Patient characteristicsPatient/sex/ Chemotherapya Time toage (y) onset (m)b
1/M/38 Chlormethine, vincristine, 50procarbazine, prednisone (MOPP);doxorubicin [Adriamycin],bleomycin, vinblastine,dacarbazine (ABVD)
2/F/68 Doxorubicin, vinblastine, 20dacarbazine (AVD)
3/M/37 Cyclophosphamide, doxorubicin, 84vincristine [Oncovin], prednisone(CHOP)
4/M/65 CHOP + rituximab 365/F/42 Doxorubicin, cyclophosphamide 36
(AC) + tamoxifen6/F/74 Cyclophosphamide, doxorubicin, 14
fluorouracil (CAF) + docetaxel7/F/68 Fluorouracil, epirubicin, 58
cyclophosphamide (FEC);tamoxifen
8/F/50 AC, docetaxel 249/F/49 Etoposide, cisplatin 1710/M/81 Goserelin, docetaxel 15611/M/58 Cyclophosphamide, vincristine, 27
doxorubicin, dexamethasone(Hyper-CVAD)
a dosages and duration of treatments not stated.b time from therapy initiation to t-AML onset.
* fludarabine, cytarabine and granulocyte colony-stimulatingfactor
Gustafson SA, et al. Therapy-related acute myeloid leukemia with t(8;21)(q22;q22) shares many features with de novo acute myeloid leukemia witht(8;21)(q22;q22) but does not have a favorable outcome. American Journal ofClinical Pathology 131: 647-655, No. 5, May 2009 - USA 801146275
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Reactions 4 Jul 2009 No. 12590114-9954/10/1259-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
