Therapy-related myeloid neoplasms - what have we learned so far?

• 作者: Mohammad Faizan Zahid Aric Parnes Bipin N Savani Mark R Litzow Shahrukh K Hashmi
• 来源期刊: 世界干细胞杂志：英文版（电子版）
• 学科: 医学
• 关键词: THERAPY-RELATED acute MYELOID leukemia THERAPY-RELATED MYELODYSPLASTIC SYNDROMES Ionizing radiation Alkylating agents Allogeneic hematopoietic stem cell transplantation TOPOISOMERASE Ⅱ inhibitors THERAPY-RELATED MYELOID NEOPLASMS
• 年，卷（期）: 2016,（8）
• 页码范围: 231-242
• 页数: 12页
• 分类号: R

摘要

Therapy-related myeloid neoplasms are neoplastic processes arising as a result of chemotherapy, radiation therapy, or a combination of these modalities given for a primary condition. The disease biology varies based on the etiology and treatment modalities patients receive for their primary condition. Topoisomerase Ⅱ inhibitor therapy results in balanced translocations. Alkylating agents, characteristically, give rise to more complex karyotypes and mutations in p53. Other etiologies include radiation therapy, high-dose chemotherapy with autologous stem cell transplantation and telomere dysfunction. Poor-risk cytogenetic abnormalities are more prevalent than they are in de novo leukemias and the prognosis of these patients is uniformly dismal. Outcome varies according to cytogenetic risk group. Treatmentrecommendations should be based on performance status and karyotype. An in-depth understanding of risk factors that lead to the development of therapyrelated myeloid neoplasms would help developing riskadapted treatment protocols and monitoring patients after treatment for the primary condition, translating into reduced incidence, early detection and timely treatment.