Antineoplastics
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Reactions 1396 - 7 Apr 2012 S Antineoplastics Myelodysplastic syndrome and acute myeloid leukaemia: 4 case reports In a retrospective study of 210 patients with chronic lymphocytic leukaemia, four patients were identified after they developed therapy-related myelodysplastic syndrome and acute myeloid leukaemia (t-MDS/AML) following treatment with antineoplastics [some dosages and routes not stated]. Three men and one woman, aged 49–71 years, received six cycles of FC chemotherapy, consisting of IV fludarabine 25 mg/m 2 and IV cyclophosphamide 200 mg/m 2 for three consecutive days in each 28-day cycle. One man had previously received two cycles of CHOP chemotherapy, consisting of cyclophosphamide, doxorubicin, vincristine and prednisolone, and four cycles of FND chemotherapy, consisting of fludarabine, mitoxantrone and dexamethasone. The female patient had received first-line treatment with six cycles of CHOP chemotherapy. The remaining two patients received FC chemotherapy as first- line treatment. At 7–56 months after completing FC treatment, a diagnosis of t-MDS/AML was suspected in all four patients. Morphological FAB types were M5b, M2, M4 and RAEB2. Two patients had trilineage myelodysplasia, while three patients had complex karyotypes and chromosome 5 abnormalities. Three patients received intensive chemotherapy with daunorubicin and cytarabine, while the remaining patient, with FAB type RAEB2, received low-dose cytarabine. Patient survival following t-MDS/AML diagnosis was 1–8 months [outcomes not clearly stated]. Author comment: "[T]wo patients had received other chemotherapeutic agents before FC – FND and CHOP in one and CHOP in the other. Mitoxantrone . . . may contribute to the DNA damaging effects of FC as suggested previously. Also, t-MDS/AML may occur after CHOP therapy, which is potentially a confounding factor in both our patients treated with CHOP prior to FC." Colovic M, et al. Therapy-related myelodysplastic syndrome and acute myeloid leukemia in patients with chronic lymphocytic leukemia treated with fludarabine and cyclophosphamide. Biomedicine and Pharmacotherapy 65: 319-21, No. 5, Aug 2011 - Serbia 803068762 1 Reactions 7 Apr 2012 No. 1396 0114-9954/10/1396-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1396 - 7 Apr 2012
SAntineoplastics
Myelodysplastic syndrome and acute myeloidleukaemia: 4 case reports
In a retrospective study of 210 patients with chroniclymphocytic leukaemia, four patients were identified afterthey developed therapy-related myelodysplastic syndromeand acute myeloid leukaemia (t-MDS/AML) followingtreatment with antineoplastics [some dosages and routesnot stated].
Three men and one woman, aged 49–71 years, receivedsix cycles of FC chemotherapy, consisting of IV fludarabine25 mg/m2 and IV cyclophosphamide 200 mg/m2 for threeconsecutive days in each 28-day cycle. One man hadpreviously received two cycles of CHOP chemotherapy,consisting of cyclophosphamide, doxorubicin, vincristineand prednisolone, and four cycles of FND chemotherapy,consisting of fludarabine, mitoxantrone anddexamethasone. The female patient had received first-linetreatment with six cycles of CHOP chemotherapy. Theremaining two patients received FC chemotherapy as first-line treatment. At 7–56 months after completing FCtreatment, a diagnosis of t-MDS/AML was suspected in allfour patients. Morphological FAB types were M5b, M2,M4 and RAEB2. Two patients had trilineagemyelodysplasia, while three patients had complexkaryotypes and chromosome 5 abnormalities.
Three patients received intensive chemotherapy withdaunorubicin and cytarabine, while the remaining patient,with FAB type RAEB2, received low-dose cytarabine.Patient survival following t-MDS/AML diagnosis was1–8 months [outcomes not clearly stated].
Author comment: "[T]wo patients had received otherchemotherapeutic agents before FC – FND and CHOP in oneand CHOP in the other. Mitoxantrone . . . may contribute tothe DNA damaging effects of FC as suggested previously.Also, t-MDS/AML may occur after CHOP therapy, which ispotentially a confounding factor in both our patients treatedwith CHOP prior to FC."Colovic M, et al. Therapy-related myelodysplastic syndrome and acute myeloidleukemia in patients with chronic lymphocytic leukemia treated with fludarabineand cyclophosphamide. Biomedicine and Pharmacotherapy 65: 319-21, No. 5, Aug2011 - Serbia 803068762
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Reactions 7 Apr 2012 No. 13960114-9954/10/1396-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
