Morphologic and Cytochemical Observations on the Overt Leukemic Phase of Therapy-related Leukemia

Vardiman, James W.; Coelho, Ana Carolina; Golomb, Harvey M.; Rowley, Janet D.

doi:10.1093/ajcp/79.5.525

Cited by 35 publications

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“…Dysplastic features of all hematopoietic lines were present in 73 per cent of cases and the abnormalities of the thrombopoietic line were prominent. In other series of t-ANLL in different neoplasms, hypercellularity was more frequent, with a comparable incidence of myelofibrosis and megakaryocytic atypia (Vardiman et al, 1983;Navone, 1984). Acute myelofibrosis has been described after cytotoxic therapy (Ali et al, 1979;Sultan et af., 1981), with an elevated number of marrow megakaryoblasts.…”

Section: Discussionmentioning

confidence: 79%

“…Morphological, clinical and cytogenetic characteristics of therapy-related leukemia (t-ANLL) and preleukemia have been previously analysed in different neoplasias (Foucar et al, 1979;Berger et al, 1981;Rowley et al, 1981;Pedersen-Bjergaard et al, 1981;Griinwald and Rosner, 1982;Vardiman et al, 1983;Zaccaria et ai., 1983;Pedersen-Bjergaard et ai., 1984;Arthur and Bloomfield, 1984;Group FranGais, 1984;Berger et al, 1984;Michels et al, 1985;Le Beau et al, 1986). We have undertaken a cooperative study among seven major institutions in Italy to analyse the features of acute leukemia developing after therapy of HD.…”

Section: Introductionmentioning

confidence: 99%

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Treatment‐related leukemia in Hodgkin's disease: A multi‐institution study on 75 cases

Brusamolino

Papa

Valagussa

et al. 1987

Hematological Oncology

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Hematological and cytogenetic characteristics of 75 cases of therapy-related acute non lymphoid leukemia (t-ANLL) occurring in Hodgkin's disease (HD) are analysed in this multi-institution study. Combined radio and chemotherapy had been given in 88 per cent of patients, either as adjuvant (44 per cent) or as salvage modality (44 per cent). Radiotherapy alone and chemotherapy alone had been given in 3 per cent and 9 per cent respectively. Eighty per cent of patients were in remission of HD and 71 per cent off-therapy while developing leukemia. The median latent time from remission of HD to leukemia was 34 months. The myeloblastic variety of leukemia accounted for 43 per cent of total cases; the myelomonocytic and monocytic for 17 per cent and 4 per cent, the promyelocytic and erythroblastic variants for 5 per cent and 7 per cent of t-ANLL. Twenty four per cent of cases were unclassifiable; one of these was TdT-positive. Dysplastic features of erythrocytic line were invariably present with circulating erythroblasts; defects of granulocytes, circulating megathrombocytes and micromegakaryocytes were also present. Bone marrow hypoplasia and marked fibrosis were documented in 47 per cent and 30 per cent of cases. Preleukemia heralded overt leukemia in 73 per cent of cases; 37 per cent had refractory anemia with no excess of blasts; 16 per cent of preleukemias were unclassifiable. Cytogenetics revealed chromosome abnormalities in 83 per cent of cases; 72 per cent presented chromosome 5 and/or 7 monosomy or partial deletion (5q- or 7q-) of the long arm (94 per cent in the combined modality therapy group). In 3 cases, a pure monosomy 7 was observed; in none 5q-alone. Response rate to conventional therapy was 14 per cent; low and high-dose cytarabine were of little benefit. Long-term CR (28 + and 16 + months) was achieved in 2 cases with allogeneic bone marrow transplantation (BMT) as first-line therapy. A better knowledge of t-ANLL in HD and new therapies, including BMT, may improve the prognosis of this late complication of intensive HD treatment.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Treatment‐related leukemia in Hodgkin's disease: A multi‐institution study on 75 cases

Brusamolino

Papa

Valagussa

et al. 1987

Hematological Oncology

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“…There are conflicting reports about the occurence of Auer rods in the cases of secondary AML. Vardiman et al 9 did not find Auer rods in 21 cases of secondary AML as compared to their presence in 42% (54/129) of de novo AML. On the other hand, Auer rods were reported in nearly 32% (12/37) cases of secondary AML in another series 10.…”

Section: Discussionmentioning

confidence: 87%

AML transformation after autologous stem cell transplant for multiple myeloma

2015

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SUMMARYA 59-year-old male patient was diagnosed as multiple myeloma in 2005 and received chemotherapy consisting of thalidomide, cyclophosphamide, and dexamethasone. The patient subsequently received high-dose melphalan followed by autologous stem cell transplantation and maintenance therapy with thalidomide. During the follow-up, the patient developed fever and cytopenias in 2012. The work up revealed 55% blasts in the marrow with myeloid phenotype leading to a diagnosis of acute myeloma leukaemia (AML). The karyotype was normal (46,XY) on conventional cytogenetics. The therapy was initiated, however, the patient expired within 1 month of diagnosis. The treatment related factors like alkylating agents are usually taken as the responsible agents for therapy-related AML, however, recent studies have proposed a multifactorial pathogenesis of leukaemic transformation in multiple myeloma. BACKGROUND

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French registry of acute leukemia and myelodysplastic syndromes. Age distribution and hemogram analysis of the 4496 cases recorded during 1982–1983 and classified according to FAB criteria

Hematologique¹

1987

Cancer

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During 1982 and 1983, 4496 new cases were recorded in the French Registry of acute leukemia and myelodysplastic syndromes by the French Group of Hematologic Morphology. This cooperative group associated members of 37 university centers spread throughout France; these centers handle the overwhelming majority of acute leukemias diagnoses. The cases were all classified according to FAB guidelines. Two thousand four hundred ninety-nine cases of acute myeloid leukemia were recorded, with similar total recruitment and distribution by cytologic subclass for both years. Hemogram data analysis revealed significant differences between different classes for certain parameters, particularly leukocytosis. A greater proportion of the acute myelogenous leukemias (AMLs) secondary to chemotherapy and/or radiotherapy (n = 145) were unclassifiable according to the French-American-British (FAB) system than the de nova AMLs (n = 1954). Eight hundred twenty cases of myelodysplastic syndromes were analyzed. Their frequency was underestimated due to optional reporting during the first year and the less favorable position of the university centers for recruiting these syndromes. The characteristics of the hemograms were established for acquired idiopathic sideroblastic anemia (n = 107), refractory anemia with excess blasts (RAEB) (n = 329), chronic myelomonocytic leukemia (n = 129) and RAEB in transformation (n = 65). Analysis of the 1177 acute lymphoblastic leukemias (ALLs) recorded showed good stability from one year to the next in terms of numbers of cases and distribution in the subclasses Ll, L2, and L3. The distribution among these three subclasses by age also was determined. For L1 and L2 the hemogram data were examined separately for adults and children. The study of 74 cases of type L3 ALL enabled us to detail the hematologic presentation of this rare form of leukemia.Cancer 60: 1385-1394.1987.HE NEED FOR CYTOLOGICAL CLASSIFICATION of the T acute leukemias (AL) has long been believed because of the morphologic diversity of these disorders. Numerous correlations were quickly discovered be-tween cytologic features and certain clinical parameters. The subsequent appearance of treatments whose efficacy was different for different cytologic types was an inducement to take blast cytology into consideration

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Morphologic and Cytochemical Observations on the Overt Leukemic Phase of Therapy-related Leukemia

Cited by 35 publications

References 0 publications

Treatment‐related leukemia in Hodgkin's disease: A multi‐institution study on 75 cases

Treatment‐related leukemia in Hodgkin's disease: A multi‐institution study on 75 cases

AML transformation after autologous stem cell transplant for multiple myeloma

French registry of acute leukemia and myelodysplastic syndromes. Age distribution and hemogram analysis of the 4496 cases recorded during 1982–1983 and classified according to FAB criteria

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