Treatment related myelodysplasia (t-MDS) or acute myeloid leukaemias (t-AML)

The study included 41 cases; t-MDS with progression to AML accounted for 7% and t-AML for the remaining 93% the AML subtype was M3 in all but one case; no case of acute lymphoblastic leukaemia

t(15;17)(q22;q21) was found in 8% of t-MDS/t-AML; sex ratio: 15M/26F

Age at diagnosis of the primary disease 46 yrs (range 18-79); age at diagnosis of the t-MDS/t-AML: 49 yrs (range 19-81). Median interval was 29 mths (range: 9-175). Primary disease was a solid tumor in 71% of cases ( breast cancer in particular) and a hematologic malignancy in 27%, treatment was radiotherapy (29%, a high proportion compared to other groups), chemotherapy (17%), or both (54%). Treatment included topoisomerase II inhibitors in 49% of cases and alkylating agents in 59%.

Median survival was 29 mths. Outcome was better than the outcome of patients with 11q23 rearrangement, 3q21q26 rearrangement, 12p13 rearrangement, t(9;22), t(8;16), or a 21q22 rearangement) and similar, during the first 2 yrs to that of the inv(16) treatment related leukemias.

5 PML -3 RARA

This data is extracted from a very large study from an International Workshop on treatment related leukemias - restricted to balanced chromosome aberrations (i.e.: -5/del(5q)and -7/del(7q) not taken into account per see), published in Genes,Chromosomes and Cancer in 2002.