1/11. Secondary myelodysplastic syndrome and leukemia following 131I-metaiodobenzylguanidine therapy for relapsed neuroblastoma.PURPOSE: To describe three patients with secondary leukemia after treatment with 131I-metaiodobenzylguanidine (MIBG) for neuroblastoma. methods: Of 95 children with refractory neuroblastoma treated with 131I-MIBG at UCSF, 3 have been identified with secondary myelodysplasia/leukemia. The case records and bone marrow results were reviewed, along with a review of the literature. RESULTS: Three patients developed secondary myelodysplasia/leukemia, at 7, 11, and 12 months following 131I-MIBG therapy. Cytogenetic abnormalities included -7q/-5, -7/ 2q37, -11 and 12. Three additional cases were found in literature review of 509 reported patients treated with 131I-MIBG for neuroblastoma. CONCLUSIONS: Therapy with 131I-MIBG may contribute to the risk of secondary leukemia in patients who have received intensive chemotherapy, thought the risk of this complication is far lower than the risk of disease progression. Further monitoring for this complication is indicated.- - - - - - - - - - ranking = 1keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
2/11. Unbalanced 6p translocation as primary karyotypic anomaly in secondary acute nonlymphocytic leukemia.A case of acute nonlymphocytic leukemia after radiochemotherapy for Hodgkin's disease, with a rearrangement of 6p23 region, is described. This chromosome change, which has been previously reported in secondary leukemias or myelodysplastic syndromes, was an isolated karyotypic anomaly in our case, which strongly supports the nonrandom involvement of chromosome 6p in induced leukemias.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
3/11. Translocation (1;6)(p12;p23) in ANLL.We report here a case of acute nonlymphocytic leukemia evolving from a myelodysplastic syndrome which developed in an elderly man who had received radiation therapy for a prior cancer. cytogenetic analysis revealed the following karyotype: 47,XY, 8,t(1;6)(p13;p23). The breakpoints in the translocation are in the regions of the NRAS1 and PIM1 oncogenes on chromosomes 1 and 6, respectively. This translocation has not been previously observed in hematological malignancies.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
4/11. Myelodysplastic syndrome and acute leukaemia following treatment of soft tissue sarcoma.The incidence of secondary myelodysplastic syndromes (MDS) and acute leukaemias (AL) after chemotherapy and/or radiotherapy is increasing. Most cases have been described in patients with Hodgkin's disease, non-Hodgkin's lymphomas, multiple myeloma, polycythemia vera, ovarian cancer and breast cancer. We report 2 patients with secondary MDS and acute myeloblastic leukaemia after combined chemotherapy and radiotherapy for soft tissue sarcoma. Five more cases have been described in the literature. The data of all patients are summarized. The occurrence of secondary MDS/AL in patients with soft tissue sarcoma may become a problem, in particular in children, who have been cured after combined radiotherapy and chemotherapy.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
5/11. Translocations and deletions with breakpoint on 21q are nonrandomly associated with treatment-related acute nonlymphocytic leukemia and preleukemia.Six of 70 (8.6%) consecutive cases with therapy-related acute nonlymphocytic leukemia (ANLL) or preleukemia had a translocation or deletion with a breakpoint on 21q. Such aberrations were seen in only one of 200 (0.5%) consecutive cases of de novo ANLL examined at our laboratory. The figures reflect a 17.1-fold increased incidence of 21q aberrations in therapy-related ANLL or preleukemia, compared with ANLL de novo. The difference is highly significant (p = 0.003). The increased incidence of 21q aberrations in therapy-related myelodysplastic syndromes was confirmed by literature studies. Band 21q22 was most often involved. Cases with t(8;21), which is strongly associated with the M2 variant of ANLL, or cases with i(21q), which is supposedly due to a centromeric misdivision, were not included in the count. It is concluded that the 21q aberrations are associated with treatment-related ANLL or preleukemia with at least the same degree of specificity as aberrations of #5 and #7.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
6/11. myeloproliferative disorders in patients with rheumatoid arthritis treated with total body irradiation.Four patients with refractory rheumatoid arthritis were treated with total body irradiation administered in two sittings, 300 to 400 rads to each half of the body. All four patients had taken antimetabolites prior to receiving total body irradiation, and two continued to use them after total body irradiation. Two patients had taken alkylating agents before, and one had used them after total body irradiation. All patients showed clinical improvement. However, in two patients myeloproliferative disorders developed: a myelodysplastic preleukemia at 40 months after total body irradiation in one and acute myelogenous leukemia at 25 months in the other. Total body irradiation differs from total nodal irradiation in the total dose of irradiation (300 to 400 rads versus 2,000 to 3,000), and in the duration of the therapy (two sittings versus treatment over several weeks to months). Furthermore, the patients in the total body irradiation study frequently used cytotoxic drugs before and/or after irradiation, whereas in one total nodal irradiation study, azathioprine (2 mg/kg per day or less) was permitted, but no other cytotoxic agents were allowed. Rheumatologists may therefore face a binding decision when deciding to treat a patient with rheumatoid arthritis with either a cytotoxic drug or irradiation.- - - - - - - - - - ranking = 0.080245893224692keywords = myelodysplastic (Clic here for more details about this article) |
7/11. Therapy related acute non-lymphocytic leukemia: report of 4 cases.Four cases of acute myelodysplastic-non-lymphocytic leukemia secondary to cytotoxic agents were reported. Primary diseases were breast cancer (1 patient), ovarian cancer (2 patients) and multiple myeloma (1 patient). All except one (with multiple myeloma) were in clinical remission of their primary diseases. Common cytotoxic agent used was melphalan. Median total drug dose and median latent period from diagnosis of primary diseases were 1299 mg and 63 months respectively. None with the exception of one received specific treatment. All died except one who is in a very poor condition. survival from the diagnosis of hematologic diseases ranged from 3-9 months. Clinical features, cytogenetic findings, pathogenetic mechanism and risk of the disease were briefly discussed.- - - - - - - - - - ranking = 0.080245893224692keywords = myelodysplastic (Clic here for more details about this article) |
8/11. Myelodysplastic syndrome in two young brothers.We report the youngest cases of myelodysplastic syndrome (MDS) in two brothers aged 7 and 2 years. The maternal grandfather and maternal grandmother had been exposed to radioactive fallout after the atomic bomb attack on Hiroshima in 1945. The elder brother demonstrated pancytopenia with < 1% blast cells in his peripheral blood and < 5% in his bone marrow at diagnosis. The younger brother was thrombocytopenic without increased blasts. The karyotype of bone marrow cells from the elder brother was 46,XY, -7, der (7), t(1:7) (lqter-lq11::7q11-7pter), but the younger brother's karyotype was normal. Immature myeloid cells in the bone marrow from both brothers were morphologically abnormal. A diagnosis of refractory anaemia (RA) was made in both brothers. Atavism due to radioactive poisoning was suspected in the development of MDS in these two cases.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
9/11. Leukemia developing after 131I treatment for thyroid cancer in a patient with Werner's syndrome: molecular and cytogenetic studies.A 40-year-old female patient with Werner's syndrome (WS) suffering from thyroid cancer and myelodysplastic syndrome (MDS) is reported. She had been diagnosed as having WS complicated with thyroid cancer seven years previously. Total thyroidectomy and radioactive iodine (131I, 100 mCi/year) therapy for seven years had slowed the progression of thyroid cancer. She suffered a sudden onset of MDS at the age of 40 years. After six months she died from overt leukemia. We found an additional chromosome aberration of chromosome 10 in the progression of leukemia from MDS.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
10/11. The heterogeneity of leukemia occurring after treatment for sarcoma.The successful treatment of sarcomas with intensive regimens combining high-dose chemotherapy and irradiation has led to not only improved survival but also to an increased incidence of therapy-related acute non-lymphocytic leukemia (t-ANLL) and myelodysplastic syndrome (MDS). We report 4 patients having sarcoma treated with chemotherapy or chemoradiotherapy who subsequently developed MDS or t-ANLL.- - - - - - - - - - ranking = 0.25keywords = myelodysplastic syndrome, myelodysplastic (Clic here for more details about this article) |
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