scholarly journals A Case of Secondary Leukemia Subsequent to Myelodysplastic Syndromes Successfully Treated with Azacitidine

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Takahiro Kumode ◽  
Ayano Fukui ◽  
Go Eguchi ◽  
Terufumi Yamaguchi ◽  
Yasuhiro Maeda
Keyword(s):  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Myelodysplastic Syndrome ◽  
Physical Condition ◽  
Myeloid Leukemia ◽  
Therapeutic Option ◽  
Tumor Burden ◽  
Secondary Leukemia ◽  
Secondary Acute Myeloid Leukemia ◽  
Acute Myeloid

Elderly patients with secondary acute myeloid leukemia (AML) following myelodysplastic syndrome (MDS) are often medically unfit for or resistant to chemotherapy, and their prognosis is dismal. In the present paper, we reported a case of secondary leukemia following MDS in an 80-year-old male patient who was deemed unfit for chemotherapy owing to his old age and poor physical condition. Despite a high tumor burden, treatment with AZA exerted a remarkable response, leading to an immediate cytoreduction in our case. Our results suggest that AZA can be an attractive therapeutic option for elderly MDS or AML patients, offering adequate efficacy and high tolerability.

Risk of Acute Myeloid Leukemia and Myelodysplastic Syndrome in Trials of Adjuvant Epirubicin for Early Breast Cancer: Correlation With Doses of Epirubicin and Cyclophosphamide

2005 ◽  
Vol 23 (18) ◽  
pp. 4179-4191 ◽  
Author(s):  
Claudio Praga ◽  
Jonas Bergh ◽  
Judith Bliss ◽  
Jacques Bonneterre ◽  
Bruno Cesana ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Myelodysplastic Syndrome ◽  
Early Breast Cancer ◽  
Myeloid Leukemia ◽  
Lower Probability ◽  
Cumulative Probability ◽  
Secondary Leukemia ◽  
Acute Myeloid

Purpose We reviewed follow-up of patients treated in 19 randomized trials of adjuvant epirubicin in early breast cancer to determine incidence, risk, and risk factors for subsequent acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Patients and Methods The patients (N = 9,796) were observed from the start of adjuvant treatment (53,080 patient-years). Cases of AML or MDS (AML/MDS) were reported, with disease characteristics. Incidence and cumulative risk were compared for possible risk factors, for assigned regimens, and for administered cumulative doses of epirubicin and cyclophosphamide. Results In 7,110 patients treated with epirubicin-containing regimens (92% of whom also received cyclophosphamide), 8-year cumulative probability of AML/MDS was 0.55% (95% CI, 0.33% to 0.78%). The risk of developing AML/MDS increased in relation to planned epirubicin dose per cycle, planned epirubicin dose-intensity, and administered cumulative doses of epirubicin and cyclophosphamide. Patients with administered cumulative doses of both epirubicin and cyclophosphamide not exceeding those used in standard regimens (≤ 720 mg/m2 and ≤ 6,300 mg/m2, respectively) had an 8-year cumulative probability of developing AML/MDS of 0.37% (95% CI, 0.13% to 0.61%) compared with 4.97% (95% CI, 2.06% to 7.87%) for patients administered higher cumulative doses of both epirubicin and cyclophosphamide. Conclusion Patients treated with standard cumulative doses of adjuvant epirubicin (≤ 720 mg/m2) and cyclophosphamide (≤ 6,300 mg/m2) for early breast cancer have a lower probability of secondary leukemia than patients treated with higher cumulative doses. Increased risk of secondary leukemia must be considered when assessing the potential benefit to risk ratio of higher than standard doses.

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