Contributions
Abstract: PB1425
Type: Publication Only
Session title: Acute myeloid leukemia - Clinical
Background
Over the years, the incidence of therapy-related myeloid neoplasm (t-MN) has increased as a consequence of the increased survival rate of cancer due to constant improvement of treatments. t-MN represents 10-20% of all myeloid neoplasms and its prognosis is relatively poor.
Aims
The aim of this study was to analyze the characteristics and the outcome of patients with t-MN.
Methods
The present retrospective study comprises a series of 23 patients with t-MN diagnosed at Hospital Universitario Guadalajara between 2009 and 2020. Electronic medical records from the database were reviewed in order to identify all cases of t-MN. The data collected included: age, sex, cytogenetics, primary malignancy type or autoimmune disease and treatment received.
Results
The median age of the patients was 72 years (range, 56 to 85 years) and 52% of them were male. Fourteen patients (61%) had preceding solid tumors (the most frequent was lung cancer), 3 patients (13%) had hematologic malignancies and 6 patients (26%) had autoimmune conditions. The median interval between primary malignant disease and t-MN diagnosis was 6.9 years (range, 0.3 to 22.5). Immunosuppressant drugs were administered to 6 patients (26%), 7 patients (30%) were treated with chemotherapy alone and 10 patients (43%) received radiation associated with chemotherapy. The type of chemotherapy received was alkylating agents alone or different combinations of alkylating, targeting topoisomerase II, alkaloids and antimetabolites agents. Patients treated with immunosuppressant drugs took longer to develop t-MN (median 10 years) and they had a better survival rate.
Unbalanced aberrations of chromosomes 5 and 7 and/or a complex karyotype were described in 7 patients (30%); all these patients had received alkylating agents and/or radiotherapy. Six (26%) patients exhibited TP53 mutation, 5 of them (83%) developed t-AML and all these 5 patients deceased due to progression of the condition, despite the treatment received (intensive anthracycline and cytarabine based chemotherapy, daunorubicin and cytarabine liposome or hypomethylating agents). The median overall survival after t-AML diagnosis was 8 months.
Conclusion
Development of t-MN is a serious complication with poor prognosis. Predictive markers should be identified in patients with cancer in order to prevent the risk of developing t-MN.
Keyword(s): Cancer, Chemotherapy toxicity, Radiotherapy, Therapy-related AML
Abstract: PB1425
Type: Publication Only
Session title: Acute myeloid leukemia - Clinical
Background
Over the years, the incidence of therapy-related myeloid neoplasm (t-MN) has increased as a consequence of the increased survival rate of cancer due to constant improvement of treatments. t-MN represents 10-20% of all myeloid neoplasms and its prognosis is relatively poor.
Aims
The aim of this study was to analyze the characteristics and the outcome of patients with t-MN.
Methods
The present retrospective study comprises a series of 23 patients with t-MN diagnosed at Hospital Universitario Guadalajara between 2009 and 2020. Electronic medical records from the database were reviewed in order to identify all cases of t-MN. The data collected included: age, sex, cytogenetics, primary malignancy type or autoimmune disease and treatment received.
Results
The median age of the patients was 72 years (range, 56 to 85 years) and 52% of them were male. Fourteen patients (61%) had preceding solid tumors (the most frequent was lung cancer), 3 patients (13%) had hematologic malignancies and 6 patients (26%) had autoimmune conditions. The median interval between primary malignant disease and t-MN diagnosis was 6.9 years (range, 0.3 to 22.5). Immunosuppressant drugs were administered to 6 patients (26%), 7 patients (30%) were treated with chemotherapy alone and 10 patients (43%) received radiation associated with chemotherapy. The type of chemotherapy received was alkylating agents alone or different combinations of alkylating, targeting topoisomerase II, alkaloids and antimetabolites agents. Patients treated with immunosuppressant drugs took longer to develop t-MN (median 10 years) and they had a better survival rate.
Unbalanced aberrations of chromosomes 5 and 7 and/or a complex karyotype were described in 7 patients (30%); all these patients had received alkylating agents and/or radiotherapy. Six (26%) patients exhibited TP53 mutation, 5 of them (83%) developed t-AML and all these 5 patients deceased due to progression of the condition, despite the treatment received (intensive anthracycline and cytarabine based chemotherapy, daunorubicin and cytarabine liposome or hypomethylating agents). The median overall survival after t-AML diagnosis was 8 months.
Conclusion
Development of t-MN is a serious complication with poor prognosis. Predictive markers should be identified in patients with cancer in order to prevent the risk of developing t-MN.
Keyword(s): Cancer, Chemotherapy toxicity, Radiotherapy, Therapy-related AML