THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA

Therapy related myeloid malignancies are an increasingly recognized treatment complication in patients undergoing therapy for multiple myeloma. The main predisposing factors are the alkylating agents, topoisomerase II inhibitors and radiotherapy, but recently questions have been raised regarding the...

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Main Authors: Xenofon Papanikolaou, Bart Barlogie, Saad Usmani
Format: Article
Language:English
Published: PAGEPress Publications 2011-10-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/294
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author Xenofon Papanikolaou
Bart Barlogie
Saad Usmani
author_facet Xenofon Papanikolaou
Bart Barlogie
Saad Usmani
author_sort Xenofon Papanikolaou
collection DOAJ
description Therapy related myeloid malignancies are an increasingly recognized treatment complication in patients undergoing therapy for multiple myeloma. The main predisposing factors are the alkylating agents, topoisomerase II inhibitors and radiotherapy, but recently questions have been raised regarding the immunomodulatory agent lenalidomide. Little is known about the new antimyeloma agents in the context of therapy related myeloid malignanices. The duration of treatment and the time from diagnosis are the main contributing factors in alkylating induced myeloid malignancies which occur 5-10 years after treatment, chromosome 5 and 7 abnormalities being the characteristic finding. High dose therapy (HDT) does not seem to be a major contributing factor per se in multiple myeloma. In a number of large published series, all the factors related with therapy-induced myelodysplasia were defined prior to HDT. Topoisomerase II inhibitors induce mainly acute leukemias which invariably correlate with dysregulation of the MLL gene. Radiotherapy causes therapy related myelodysplasia if applied in bone marrow producing areas, especially if combined with chemotherapy. Therapy related myeloid malignancies generally herald a poor prognosis. Karyotypic abnormalities seem to be the main prognostic factor. In all cases the risk for therapy related myeloid malignancies drops sharply by 10 years after the treatment.
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spelling doaj-art-2c34976817804011a3af5a5eaac13cac2025-01-02T11:15:16ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062011-10-0131e2011047e201104710.4084/mjhid.2011.047186THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMAXenofon Papanikolaou0Bart BarlogieSaad Usmani, AND SAAD Z. USMANITherapy related myeloid malignancies are an increasingly recognized treatment complication in patients undergoing therapy for multiple myeloma. The main predisposing factors are the alkylating agents, topoisomerase II inhibitors and radiotherapy, but recently questions have been raised regarding the immunomodulatory agent lenalidomide. Little is known about the new antimyeloma agents in the context of therapy related myeloid malignanices. The duration of treatment and the time from diagnosis are the main contributing factors in alkylating induced myeloid malignancies which occur 5-10 years after treatment, chromosome 5 and 7 abnormalities being the characteristic finding. High dose therapy (HDT) does not seem to be a major contributing factor per se in multiple myeloma. In a number of large published series, all the factors related with therapy-induced myelodysplasia were defined prior to HDT. Topoisomerase II inhibitors induce mainly acute leukemias which invariably correlate with dysregulation of the MLL gene. Radiotherapy causes therapy related myelodysplasia if applied in bone marrow producing areas, especially if combined with chemotherapy. Therapy related myeloid malignancies generally herald a poor prognosis. Karyotypic abnormalities seem to be the main prognostic factor. In all cases the risk for therapy related myeloid malignancies drops sharply by 10 years after the treatment.http://www.mjhid.org/index.php/mjhid/article/view/294Myeloma, Therapy related leukemia, Therapy related neoplasm
spellingShingle Xenofon Papanikolaou
Bart Barlogie
Saad Usmani
THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
Mediterranean Journal of Hematology and Infectious Diseases
Myeloma, Therapy related leukemia, Therapy related neoplasm
title THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
title_full THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
title_fullStr THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
title_full_unstemmed THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
title_short THERAPY-RELATED MYELOID MALIGNANCIES IN MYELOMA
title_sort therapy related myeloid malignancies in myeloma
topic Myeloma, Therapy related leukemia, Therapy related neoplasm
url http://www.mjhid.org/index.php/mjhid/article/view/294
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AT bartbarlogie therapyrelatedmyeloidmalignanciesinmyeloma
AT saadusmani therapyrelatedmyeloidmalignanciesinmyeloma