Antineoplastics
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Reactions 1292 - 13 Mar 2010 S Antineoplastics Myelodysplastic syndrome and acute myeloid leukaemia: 6 case reports Six women were hospitalised with myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML) following breast cancer (BC) treatment [see table for patient characteristics]. Two patients had also been treated for ovarian cancer (patients 4 and 6). Initial treatment for BC consisted of mastectomy (patients 1 and 6), bilateral mastectomy (patients 4 and 5) or lumpectomy and radiation (patients 2 and 3). Adjuvant chemotherapy consisted of various antineoplastics including cyclophosphamide, doxorubicin, paclitaxel, capecitabine, letrozole, tamoxifen, fluorouracil, trastuzumab [Herceptin] and methotrexate [dosages not stated]. Patient 6 did not receive adjuvant chemotherapy for breast cancer but had received carboplatin and paclitaxel for ovarian cancer; patient 4 had also received carboplatin and paclitaxel for ovarian cancer [dosages not stated]. Time from chemotherapy to development of MDS or AML was 1–7 years, and all patients presented with symptoms such as bruising, fatigue or fever. Subsequent abnormal haemograms prompted evaluation from their oncologists; MDS or AML were diagnosed from bone marrow aspiration and biopsy. Cytogenetics were normal in patients 1 and 3; patients 2 and 5 had inversions of chromosome 16; patient 4 had loss of chromosomes 5, 7, 9 and 21, as well as trisomy 8; patient 6 had additions of chromosomes 5, 6 and 11, and deletion of chromosome 12. Additionally, patients 4, 5, and 6 were found to have BRCA gene mutations. The women were admitted for management [treatments and patient outcomes not stated]. Patient Characteristics Pt/sex/ Chemotherapy Time to Type of AML or age (y) onset (y) a MDS 1/F/37 Cyclophosphamide, 2 FAB M4 doxorubicin, paclitaxel, capecitabine b 2/F/65 Cyclophosphamide, 1 FAB M4 with doxorubicin, paclitaxel b eosinophilia 3/F/70 Cyclophosphamide, 2 FAB M4 doxorubicin, paclitaxel, letrozole, tamoxifen b 4/F/55 Paclitaxel, carboplatin; c 7 MDS RAEB 2 cyclophosphamide, methotrexate, fluorouracil, doxorubicin b 5/F/54 Cyclophosphamide, 2 FAB M4 with doxorubicin, paclitaxel, eosinophilia trastuzumab b 6/F/78 Paclitaxel, carboplatin c 1 FAB M4 FAB: French-American-British; RAEB: refractory anaemia with excess blasts a Time from chemotherapy to development of MDS or AML b Treatment for breast cancer c Treatment for ovarian cancer Cole M, et al. Acute myelogenous leukemia and myelodysplasia secondary to breast cancer treatment: case studies and literature review. [Review] [28 refs]. American Journal of the Medical Sciences 339: 36-40, No. 1, Jan 2010 - USA 803007272 1 Reactions 13 Mar 2010 No. 1292 0114-9954/10/1292-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1292 - 13 Mar 2010
SAntineoplastics
Myelodysplastic syndrome and acute myeloidleukaemia: 6 case reports
Six women were hospitalised with myelodysplasticsyndrome (MDS) or acute myeloid leukaemia (AML)following breast cancer (BC) treatment [see table for patientcharacteristics]. Two patients had also been treated forovarian cancer (patients 4 and 6).
Initial treatment for BC consisted of mastectomy(patients 1 and 6), bilateral mastectomy (patients 4 and 5)or lumpectomy and radiation (patients 2 and 3). Adjuvantchemotherapy consisted of various antineoplasticsincluding cyclophosphamide, doxorubicin, paclitaxel,capecitabine, letrozole, tamoxifen, fluorouracil,trastuzumab [Herceptin] and methotrexate [dosages notstated]. Patient 6 did not receive adjuvant chemotherapyfor breast cancer but had received carboplatin andpaclitaxel for ovarian cancer; patient 4 had also receivedcarboplatin and paclitaxel for ovarian cancer [dosages notstated]. Time from chemotherapy to development of MDSor AML was 1–7 years, and all patients presented withsymptoms such as bruising, fatigue or fever. Subsequentabnormal haemograms prompted evaluation from theironcologists; MDS or AML were diagnosed from bonemarrow aspiration and biopsy. Cytogenetics were normalin patients 1 and 3; patients 2 and 5 had inversions ofchromosome 16; patient 4 had loss of chromosomes 5, 7, 9and 21, as well as trisomy 8; patient 6 had additions ofchromosomes 5, 6 and 11, and deletion ofchromosome 12. Additionally, patients 4, 5, and 6 werefound to have BRCA gene mutations.
The women were admitted for management [treatmentsand patient outcomes not stated].
Patient CharacteristicsPt/sex/ Chemotherapy Time to Type of AML orage (y) onset (y)a MDS
1/F/37 Cyclophosphamide, 2 FAB M4doxorubicin, paclitaxel,capecitabineb
2/F/65 Cyclophosphamide, 1 FAB M4 withdoxorubicin, paclitaxelb eosinophilia
3/F/70 Cyclophosphamide, 2 FAB M4doxorubicin, paclitaxel,letrozole, tamoxifenb
4/F/55 Paclitaxel, carboplatin;c 7 MDS RAEB 2 cyclophosphamide,methotrexate,fluorouracil,doxorubicinb
5/F/54 Cyclophosphamide, 2 FAB M4 withdoxorubicin, paclitaxel, eosinophiliatrastuzumabb
6/F/78 Paclitaxel, carboplatinc 1 FAB M4
FAB: French-American-British; RAEB: refractory anaemia with excessblastsa Time from chemotherapy to development of MDS or AMLb Treatment for breast cancerc Treatment for ovarian cancer
Cole M, et al. Acute myelogenous leukemia and myelodysplasia secondary tobreast cancer treatment: case studies and literature review. [Review] [28 refs].American Journal of the Medical Sciences 339: 36-40, No. 1, Jan 2010 -USA 803007272
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Reactions 13 Mar 2010 No. 12920114-9954/10/1292-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
