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

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."


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

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