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:2/10/2016)... ... February 10, 2016 , ... Sherly Sulaiman, certified ... series of therapeutic sessions to help Los Angeles-area actors cope with rejection, improve ... The series, known as “Mindfulness for Actors and Artists,” has been featured in ...
(Date:2/10/2016)... , ... February 10, 2016 , ... LaserShip, a regional ... to the Food Bank of Eastern Michigan last Friday in order to aid in ... into the Midwest to include a facility located in Clio, only 15 miles away ...
(Date:2/10/2016)... ... February 10, 2016 , ... ... to expand dental health services to the developmentally disabled in the Coachella Valley. ... operations to a new facility at 71-949 Highway 111, Suite 100-B, in Rancho ...
(Date:2/10/2016)... ... 10, 2016 , ... As part of its ongoing series of aquatic therapy ... webinar features a dynamic expert and thoughtful presentation to give attendees a better sense ... Both events are free to attend, but registration is required. , Rehabilitation ...
(Date:2/10/2016)... ... 10, 2016 , ... Intermedix announced on Wednesday that it ... emergency medicine professional association, to support the organization's newly established physician group with ... Emergency Medicine, or AAEM, seeks to empower emergency physicians to control their own ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... a major "team investment" by Bruce Montgomery , one of this area,s most prominent biotech ... Leen Kawas , PhD. Photo - ... ... ... Kawas said the round was intended to be an $8 ...
(Date:2/11/2016)... , Feb. 11, 2016  AcelRx Pharmaceuticals, Inc. ... presentation will be made at the 38th annual ... Wound Care Symposium, which is being held February 14-18, ... conference covers the latest advancements in wound healing, burn ... American Burn Association, Australian-New Zealand Burns Association, Academy of ...
(Date:2/11/2016)... TEL AVIV, Israel , Feb. 11, 2016  Galmed ... clinical-stage biopharmaceutical company focused on the development of a ... announced today that its Chief Medical Officer, Dr. ... retiring from Galmed as Chief Medical Officer and from ... 2016 due to her reaching retirement age. ...
Breaking Medicine Technology: