Ann Lab Med.  2013 Mar;33(2):97-104. 10.3343/alm.2013.33.2.97.

Therapy-Related Myeloid Neoplasms in 39 Korean Patients: A Single Institution Experience

Affiliations
  • 1Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. heejinkim@skku.edu
  • 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Therapy-related myeloid neoplasms (t-MN) occur as late complications of cytotoxic therapy. This study reviewed clinical and cytogenetic characteristics of patients with t-MN at a single institution in Korea.
METHODS
The study subjects included 39 consecutive patients diagnosed with t-MN. Each subject's clinical history of previous diseases, treatments, and laboratory data was reviewed, including cytogenetics. The primary diagnosis was hematologic malignancy in 14 patients and solid tumor in 25 patients.
RESULTS
Therapy-related acute myeloid leukemia (t-AML, 66.7%) was found to be more common than therapy-related myelodysplastic syndrome (t-MDS). Primary hematologic malignancies that were commonly implicated included mature B-cell neoplasm and acute leukemia. Breast cancer was the most common primary solid tumor. The mean time interval from cytotoxic therapy initiation to t-MN detection was 49 months. Chromosomal aberrations were observed in 35 patients, and loss of chromosome 5, 7, or both accounted for 41% of all cases. Balanced rearrangements occurred in 13 patients; these patients showed shorter latency intervals (mean, 38 months) than patients with loss of chromosome 5 or 7 (mean, 61 months).
CONCLUSIONS
In this study, we determined the clinical and cytogenetic characteristics of Korean patients with t-MN. Although our results were generally consistent with those of previous reports, we found that t-MN resulting from de novo leukemia was common and that t-AML was more common than t-MDS at presentation. Multi-institutional studies involving a larger number of patients and additional parameters are required to investigate the epidemiology, genetic predisposition, and survival rate of t-MN in Korea.

Keyword

Therapy-related neoplasms; Myelodysplastic syndrome; Acute myeloid leukemia; Cytogenetics; Korea

MeSH Terms

Adolescent
Adult
Aged
Antineoplastic Agents/*adverse effects/therapeutic use
Asian Continental Ancestry Group
Bone Marrow/pathology
Breast Neoplasms/drug therapy/pathology/radiotherapy
Child
Child, Preschool
Chromosome Aberrations
Chromosomes, Human, Pair 5
Chromosomes, Human, Pair 7
Female
Hematologic Neoplasms/drug therapy/pathology/radiotherapy
Humans
Karyotyping
Leukemia, Myeloid, Acute/*diagnosis/etiology/genetics
Male
Middle Aged
Myelodysplastic Syndromes/*diagnosis/etiology/genetics
Neoplasms, Second Primary/*diagnosis/etiology/genetics
Republic of Korea
Young Adult
Antineoplastic Agents

Figure

  • Fig. 1 Morphology of the neoplastic cells of AML (A, B) and of subsequent t-AML (C, D) in patient H11. (A) Bone marrow aspirate smear (Wright-Giemsa stain, ×1,000) demonstrating myeloblast morphology. (B) Bone marrow biopsy section (H&E, ×200) demonstrating a uniform blast infiltrate. (C) Bone marrow aspirate smear (Wright-Giemsa, ×1,000) showing dysplastic megakaryocytes and increased blasts. (D) Biopsy section (H&E, ×200) showing prominent dysplastic megakaryocytes.Abbreviation: H&E, hematoxylin and eosin stain.


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Sang Hyuk Park, Hyun-Sook Chi, Young-Uk Cho, Seongsoo Jang, Chan-Jeoung Park
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