Navigation Links
Risk of leukemia after cancer chemotherapy persists
Date:2/14/2013

(WASHINGTON)- While advancements in cancer treatment over the last several decades have improved patient survival rates for certain cancers, some patients remain at risk of developing treatment-related leukemia, according to results of a study published online today in Blood, the Journal of the American Society of Hematology (ASH).

Chemotherapy is often a highly effective treatment for cancer, but certain drugs have also been shown in a range of studies to increase a patient's risk of developing therapy-related acute myeloid leukemia (tAML), a rare but frequently fatal condition. Thanks to significant advancements in therapy resulting in improved patient survival rates for certain cancers over the last several decades, researchers and clinicians now aim to design treatment regimens that maximize patient survival while minimizing short- and long-term complications.

"In the course of improving interventions and survival rates in many types of cancer, we have learned that certain chemotherapies can cause damage to cells in the bone marrow, increasing a patient's risk of leukemia. However, no recent large-scale studies have evaluated how the risk of treatment-related leukemia has evolved with the changing treatment strategies," said Lindsay Morton, PhD, of the National Cancer Institute (NCI) and lead author of the study.

To examine how the risk of tAML has evolved over time among cancer patients treated with chemotherapy, Dr. Morton and a team of researchers at the NCI's Division of Cancer Epidemiology and Genetics evaluated data from cancer registries in the U.S. Surveillance, Epidemiology, and End Results (SEER) Program, identifying adult patients ages 20-84 who were diagnosed with cancer (any type) between 1975 and 2008 and who were treated with chemotherapy. SEER data files were reviewed to determine tAML risk based on first type of cancer, time since diagnosis, age at diagnosis, and year of diagnosis.

Among the 426,068 patients whose data were eligible for analysis, Dr. Morton's team confirmed 801cases of tAML, nearly five times more than the number of cases expected in the general population. To help explain the changes in relative risk over time, investigators compared the trends in the data with evolving treatment recommendations and major therapeutic discoveries as described in the medical literature. While patient information in the SEER database did not include data on specific drugs or doses, the incidence trends were consistent with changing treatment practices and the toxicities associated with certain chemotherapies. Notably, the proportion of patients receiving chemotherapy, both with or without radiotherapy, increased during the study period for many malignancies.

As the team compared tAML risks with trends in cancer treatment over time, they analyzed several factors that likely contributed to the differences in risk between patients, including the type of cancer initially diagnosed and the year of diagnosis. For example, trends in risk for breast cancer patients (which comprised roughly one-third of tAML cases in the study) correlated to changes in breast cancer treatment protocols over the last several decades, suggesting that the decrease in tAML risk observed among breast cancer survivors in the 1980s might be attributable to an increased use of cyclophosphamide-based chemotherapy, which is less likely to cause leukemia than earlier treatment options.

A similar decline in risk was observed among ovarian cancer patients, possibly linked to a shift in ovarian cancer chemotherapy treatment in the 1970s from melphalan, a type of chemotherapy that has been shown to trigger leukemia, to a less toxic platinum-based chemotherapy. In contrast, tAML risks increased over the last several decades among patients treated with chemotherapy for non-Hodgkin lymphoma (NHL), possibly as a result of improvements in survival for patients who received multiple courses of treatment.

Further, Dr. Morton's team identified newly elevated tAML risks for patients treated with chemotherapy since 2000 for esophageal, anal, cervical, and prostate cancers, and since the 1990s for bone/joint and endometrial cancers risks that could potentially be related to expanding use of chemotherapy in recent years. Patients diagnosed with myeloma today still face some of the highest risks for tAML, possibly due to the ongoing use of melphalan to fight the aggressive disease.

The database analysis also found that relative tAML risk for many patients tended to decline with increasing time since initial cancer diagnosis. For those with non-hematologic malignancies, there was no evidence of elevated tAML risks more than 10 years following diagnosis, whereas risks persisted more than 10 years after diagnosis for patients with Hodgkin lymphoma (HL), NHL, and myeloma. Heightened tAML risk among these patients could be linked to the higher intensity and longer duration of their treatment.

"Future studies should identify patients at the highest risk of tAML so that the risks can be weighed against the benefits of chemotherapy, particularly for cancers with favorable long-term survival," said Dr. Morton. "Further research is also warranted to assess the risks associated with new targeted and immunomodulatory agents by including secondary malignancies such as tAML as endpoints in prospective clinical studies of new agents or new uses of standard agents."


'/>"/>

Contact: Andrea Slesinski
aslesinski@hematology.org
American Society of Hematology
Source:Eurekalert

Related medicine news :

1. To prevent leukemias dreaded return, go for the stem cells
2. Chemotherapy proves life-saving for some leukemia patients who fail induction therapy
3. Study Shows New Option for Kids With Tough-to-Treat Leukemia
4. Therapy exploits addiction of leukemia cells
5. Study identifies potential treatment for lethal childhood leukemia
6. A microRNA prognostic marker identified in acute leukemia
7. VCU Massey Cancer Center sees potential in novel leukemia treatment
8. Inherited DNA change explains overactive leukemia gene
9. New drug strategy attacks resistant leukemia and lymphoma
10. Researchers identify a life-and-death molecule on chronic leukemia cells
11. Child CT Scans Might Up Risk of Brain Cancer, Leukemia
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/11/2016)... ... 11, 2016 , ... PharmMD CEO Robert Yeager ... focus on contract negotiations, corporate strategy and healthcare data law. Additional responsibilities will ... in data breaches for the Part D Star Rating improvement and Medication Therapy ...
(Date:2/11/2016)... ... February 11, 2016 , ... AccuVein Inc. announces the Infusion ... of Practice, to include vascular visualization as a standard practice. AccuVein ( http://www.accuvein.com ... the market, facilitates adherence to this standard with its easy to use, widely ...
(Date:2/11/2016)... ... February 11, 2016 , ... The annual list showcases the 20 ... DataPoint’s team dedication and commitment to the SharePoint ecosystem. A panel of ... The panel’s goal is to recognize and promote technology entrepreneurship. , The survey ...
(Date:2/11/2016)... ... February 11, 2016 , ... ... and ergoFET force gauges used in physical therapy, occupational therapy and sports medicine ... for resistance cord exercise and therapy, introduces its new microFET Digital Pinch Gauge. ...
(Date:2/11/2016)... , ... February 11, 2016 , ... ... results in significantly higher rates of several common cancer screenings, especially among women. ... better outcomes and survival rates. , The study,“What Does Medicaid Expansion Mean ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... -- --> --> Transparency ... titled "Sports Medicine Devices Market - Global Industry Analysis, Size, ... the report, the global sports medicine devices market is anticipated ... growing from a value of US$6.1 bn in 2012 to ... --> The global sports medicine devices market is fueled ...
(Date:2/11/2016)... , Feb. 11, 2016 PLAD, Inc. ... out 2016 with sales exceeding company targets, are adding ... received their trademark from the United States Patent and ... Clark , Chief Executive Officer of PLAD, Inc.  In ... Pennsylvania with two new customers, ...
(Date:2/11/2016)... , Feb. 11, 2016 Exactus ... company providing high-quality specialty pharmacy care for those ... today it has achieved full Specialty Pharmacy Accreditation ... organization dedicated to promoting health care quality through ... --> The URAC accreditation process ...
Breaking Medicine Technology: