Japanese Journal of Clinical Oncology, Vol 29, Issue 1 28-32, Copyright © 1999 by Foundation for Promotion of Cancer Research
M Ando, M Narabayashi, T Watanabe, Y Kamiya, K Togitani, R Tanosaki, T Takenaka, K Tobinai and I Adachi
BACKGROUND: Accumulation of data regarding therapy-related leukemia (TRL)
or myelodysplastic syndrome (t-MDS) is critical for assessing the risk of
developing such diseases and for subsequent decision-making processes for
better treatment. METHODS: We evaluated the clinical characteristics of
patients with TRL/t-MDS diagnosed at the National Cancer Center Hospital
between January 1989 and September 1997. This report is concerned with
those patients who initially had been treated with chemotherapeutic agents
for breast cancer. RESULTS: Thirteen patients (median age, 55 years)
developed TRL (n = 4) or t-MDS (n = 9). The median interval between the
development of TRL/t-MDS and initial treatment was 94 months (range 23-190
months). For the primary therapy, all patients had received intense and
prolonged treatment with cyclophosphamide (CPA) and/or anthracyclines
including doxorubicin (DOX), with a median cumulative dose of 55 g/body
(range 16.4-288.5 g) for CPA and 480 mg/m2 (range 395-625.5 mg/m2) for DOX.
Seven patients were subsequently treated by chemotherapy and one received
an allogeneic bone marrow transplantation. CONCLUSIONS: Clinicians must
remain alert to the risks associated with unproven medical practices which
include long-term administration of alkylating agents. Selected patients
with TRL/t-MDS may respond to intense salvage combination chemotherapy.
ORIGINAL ARTICLE
Therapy-related leukemia and myelodysplastic syndrome in breast cancer patients treated with cyclophosphamide or anthracyclines
Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
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