Risk for Developing Myelodysplastic Syndromes in Prostate Cancer Patients Definitively Treated With Radiation

Mukherjee, Sudipto; Reddy, Chandana A.; Ciezki, Jay P.; Abdel‐Wahab, May; Tiu, Ramon V.; Copelan, Edward A.; Advani, Anjali S.; Saunthararajah, Yogen; Paulic, Katarina; Hobson, Sean; Maciejewski, Jaroslaw P.; Bolwell, Brian J.; Kalaycio, Matt; Dreicer, Robert; Klein, Eric; Sekeres, Mikkael A.

doi:10.1093/jnci/djt462

Cited by 21 publications

(16 citation statements)

References 59 publications

(99 reference statements)

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“…Our findings of a similar incidence of adverse-risk cytogenetics in second MN and de novo MN (Table 3) indicate that a history of previous breast cancer in itself does not necessarily carry a cytogenetic risk of subsequent MN, and a higher incidence of adverse-risk cytogenetics in t-MN (but not in second MN) than in de novo MN (Table 1 and 2) indicate that chemotherapy and/or radiation therapy play a major role in the development of t-MN, 1,28-30 although recent report that that radiation did not increase risk of subsequent MDS. 31 These findings are supported by a recent population-based study that found stage III breast cancer is associated with a significantly higher risk of subsequent diagnosis of AML than stage I breast cancer, suggesting that AML may be a sequela of treatment. 32 …”

Section: Discussionsupporting

confidence: 56%

Myeloid neoplasms after breast cancer: “therapy-related” not an independent poor prognostic factor

Chen

Estrov

Pierce

et al. 2014

Leukemia & Lymphoma

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Summary Two hundred thirty-five consecutive patients presenting to a single center with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) after breast cancer treatment were compared with matched patients with de novo AML or MDS. There was no significant difference in median OS times between patients with therapy related AML and those with de novo AML (8.7 months vs. 10.2 months; P=.17). Patients with therapy related MDS had slightly lower median baseline platelet counts and a higher frequency of poor cytogenetics than those with de novo MDS, but the two groups had similar OS times (13.6 months vs. 18.9 months; P = .06). Multivariate analysis revealed that cytogenetic risk, baseline white blood cell count, age, and performance status were predictive for OS time in AML and that cytogenetic risk and performance status were predictive for OS time in MDS. Having therapy-related disease is not an independent risk factor in patients with myeloid neoplasms and with a history of breast cancer. Clinical trials should be designed to serve both populations.

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Section: Discussionsupporting

confidence: 56%

Myeloid neoplasms after breast cancer: “therapy-related” not an independent poor prognostic factor

Chen

Estrov

Pierce

et al. 2014

Leukemia & Lymphoma

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“…The hope is that decreasing radiation fields of exposure and doses will be less leukemogenic, as suggested by a more recent cohort of t-MN patients receiving radiation monotherapy that had clinical and cytogenetic features more similar to de novo myeloid neoplasms 45 . Furthermore, external beam radiotherapy or brachytherapy for prostate cancer may not be associated with increased risk of MDS 46 .…”

Section: Exposuresmentioning

confidence: 99%

Therapy-related myeloid neoplasms: when genetics and environment collide

2017

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Therapy-related myeloid neoplasms (t-MN) arise as a late-effect of chemotherapy and/or radiation administered for a primary condition, typically a malignant disease, solid organ transplant, or autoimmune disease. Survival is measured in months, not years, making t-MN one of the most aggressive and lethal cancers. In this review, we discuss recent developments that reframe our understanding of the genetic and environmental etiology of t-MN. Emerging data illuminate who is at highest risk for developing t-MN, why t-MN is chemoresistant, and how we may use this information to treat and ultimately prevent this dreaded disease.

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“…However, this study was limited by a relatively short follow up period of around 3 years and further it did not report on the risk of developing AML or the combined risk of developing AML and/or MDS [23]. Two other studies have reported an increased risk of AML and MDS in those who received external beam radiation (hazard ratio HR = 2.05, 95% CI: 1.29-3.26) [24] as well as those who received intensity-modulated radiotherapy (HR = 1.66, 95% CI: 1.09-2.54) [25] for the treatment of prostate cancer when compared with patients who did not receive radiation.…”

Section: Epidemiology Of T-mds After Therapeutic Radiation Exposurementioning

confidence: 99%

Therapy-related myelodysplastic syndromes, or are they?

et al. 2017

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Risk for Developing Myelodysplastic Syndromes in Prostate Cancer Patients Definitively Treated With Radiation

Abstract: With relatively short follow-up, prostate cancer patients definitively treated with radiation did not appear to have a statistically increased risk of subsequent MDS.

Cited by 21 publications

References 59 publications

Myeloid neoplasms after breast cancer: “therapy-related” not an independent poor prognostic factor

Myeloid neoplasms after breast cancer: “therapy-related” not an independent poor prognostic factor

Therapy-related myeloid neoplasms: when genetics and environment collide

Therapy-related myelodysplastic syndromes, or are they?

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