Therapy-related leukemia and myelodysplastic syndrome: A large-scale Japanese study of clinical and cytogenetic features as well as prognostic factors

Citation
K. Takeyama et al., Therapy-related leukemia and myelodysplastic syndrome: A large-scale Japanese study of clinical and cytogenetic features as well as prognostic factors, INT J HEMAT, 71(2), 2000, pp. 144-152
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
INTERNATIONAL JOURNAL OF HEMATOLOGY
ISSN journal
0925-5710 → ACNP
Volume
71
Issue
2
Year of publication
2000
Pages
144 - 152
Database
ISI
SICI code
0925-5710(200002)71:2<144:TLAMSA>2.0.ZU;2-H
Abstract
It is known that alkylating agents and topoisomerase II inhibitors can caus e distinct forms of therapy-related leukemia and myelodysplastic syndrome ( TRL/MDS). Although several reports have been made on each of these agents s eparately, no study has yet been conducted to evaluate the effect of these two types of agents in the same population. In a nationwide, large-scale po pulation study, the clinical and cytogenetic features as well as the progno stic factors in 256 patients with TRL/MDS were assessed. Median age was 61 years, and the median period of latency from primary malignancies was 47.9 months. The latency period was significantly shorter in patients undergoing chemotherapy, especially that of topoisomerase II inhibitors, for primary cancer. The morphological diagnosis of TRL/MDS was acute myeloid leukemia i n 59% and MDS in 41% of patients. Chromosome abnormalities that frequently involved chromosomes 5, 7, or 11 were documented in 77% of the 189 patients examined. MLL gene rearrangements were detected in 11 of 58 subjects and w ere correlated with a borderline significance (P = 0.072) with topoisomeras e II inhibitor administration. Overall median survival was only 9.7 months. Survival was similar in cases with or without MLL gene rearrangement. Mult ivariate analysis identified chromosome 5 abnormalities, hypoproteinemia, p oor therapy outcomes for primary cancer, C-reactive protein, and thrombocyt openia as being significantly poor prognostic factors (P < 0.05). This larg e-population study provided a comprehensive update of TRL/MDS status in Jap an, identified significant prognostic factors, and enabled the clinical sig nificance of MLL gene rearrangement to be assessed. (C) 2000 The Japanese S ociety of Hematology.