Therapy-Related Myeloid Neoplasms

Author:

Bueso-Ramos Carlos E.1,Kanagal-Shamanna Rashmi1,Routbort Mark J.1,Hanson Curtis A.2

Affiliation:

1. Division of Pathology and Laboratory Medicine, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston

2. The Division of Hematopathology, Mayo Clinic, Rochester, MN

Abstract

Abstract Objectives In the 2008 World Health Organization classification, cases of acute myeloid leukemia (AML) and myelodysplastic syndrome that arise after chemotherapy or radiation therapy for a primary neoplasm are considered together as therapy-related myeloid neoplasms (TR-MNs). This concept, however, is not universally accepted since there are confounding variables in attributing myeloid neoplasms to earlier therapies. Methods Cases in session 6 of the 2013 Workshop of the Society for Hematopathology/European Association for Haematopathology illustrated myeloid neoplasms thought likely to be TR-MNs, and discussed the differences and biologic similarities with de novo myeloid neoplasms. Results We reviewed data showing that diagnosis of TR-MN alters patient outcome only in specific subsets. The session also included examples of therapy-related AML with recurrent genetic abnormalities, such as t(15;17), inv(16), and t(8;21), and reports were highlighted showing that patients with these neoplasms have clinical outcomes similar to patients with their de novo counterparts. Conclusions The study of TR-MNs will likely provide insight into the pathogenesis of de novo myeloid disease and may explain why some patients with cancer develop TR-MN and evidently have a higher genetic susceptibility, whereas most patients treated with the same agents do not. These studies will also result in critical reappraisal of current concepts related to TR-MNs.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

Reference46 articles.

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2. Myeloid neoplasms after breast cancer: “therapy-related” not an independent poor prognostic factor;Chen;Leuk Lymphoma,2014

3. Characteristics and outcomes of patients with multiple myeloma who develop therapy-related myelodysplastic syndrome, chronic myelomonocytic leukemia, or acute myeloid leukemia;Pemmaraju;Clin Lymphoma Myeloma Leuk,2014

4. Patterns of second primary malignancy risk in multiple myeloma patients before and after the introduction of novel therapeutics;Razavi;Blood Cancer J,2013

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