Abstract | BACKGROUND: METHODS: RESULTS: Sixteen patients (2.49%) developed secondary acute myelogenous leukemia (AML) (6 patients) or myelodysplastic syndrome (MDS) (10 patients). At the time of ALL diagnosis, the median age was 53 years; cytogenetics were normal in 11 patients, pseudo-diploidy with del(2) in 1 patient, t(9;22) in 1 patient, and unavailable in 3 patients. Frontline therapy included hyper-CVAD in 7 patients, hyper-CVAD with rituximab in 8 patients, and hyper-CVAD with imatinib in 1 patient. Karyotype at time of AML/MDS diagnosis was -5, -7 in 9 patients, normal in 1 patient, complex in 1 patient, inv(11) in 1 patient, t(4;11) in 1 patient, del(20) in 1 patient, and unavailable in 2 patients. Secondary AML/MDS developed at a median of 32 months after ALL diagnosis. Cytarabine plus anthracycline-based treatment was given to 12 patients with AML and high-risk MDS. One patient with MDS received arsenic trioxide, 1 received clofarabine, and 2 received decitabine. Response to treatment was complete remission in 3 patients, partial remission in 6 patients, and no response in 6 patients; 1 patient was untreated. Eight patients (1 with AML and 7 with MDS) underwent allogeneic stem cell transplantation, and all but 2 died at a median of 3 months (range, 0.5-11 months) after transplantation. The median overall survival after a diagnosis of secondary AML and MDS was 9.25 months (range, 1+ to 26+ months). CONCLUSIONS: Secondary AML and MDS occur infrequently in adult patients with de novo ALL treated with the hyper-CVAD regimens, and response to therapy is poor.
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Authors | Dushyant Verma, Susan O'Brien, Deborah Thomas, Stefan Faderl, Charles Koller, Sherry Pierce, Partow Kebriaei, Guillermo Garcia-Manero, Jorge Cortes, Hagop Kantarjian, Farhad Ravandi |
Journal | Cancer
(Cancer)
Vol. 115
Issue 1
Pg. 101-6
(Jan 01 2009)
ISSN: 0008-543X [Print] United States |
PMID | 19090005
(Publication Type: Journal Article)
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Copyright | Copyright (c) 2008 American Cancer Society. |
Chemical References |
- Vincristine
- Dexamethasone
- Doxorubicin
- Cyclophosphamide
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Cyclophosphamide
(administration & dosage)
- Dexamethasone
(administration & dosage)
- Doxorubicin
(administration & dosage)
- Drug Administration Schedule
- Humans
- Leukemia, Myeloid, Acute
(chemically induced)
- Middle Aged
- Myelodysplastic Syndromes
(chemically induced)
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy)
- Vincristine
(administration & dosage)
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