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acute myeloid leukemia, therapy related
Etiology:
1) alkylating agent related AML & myelodysplastic syndrome
2) topoisomerase II inhibitor related AML, usually epipodophyllotoxins, also anthracyclines
Epidemiology:
1) usually 5-6 year latency period (1)
2) shorter latency period, median 33-34 months (2)
Genetics:
1) unbalanced translocations or deletions of chromosomes 5 & or 7
- also chromosomes 1,4, 12, 14, 18 involvement
2) predominantly balanced translocation involving 11q23
Clinical manifestations:
1) frequently presents with myelodysplastic syndrome, bone marrow failure
a) ~2/3 refractory anemia with multilineage dysplasia
b) usually involves all myeloid cell lines
2) usually no preceding myelodysplastic phase
- most cases acute monoblastic leukemia or acute myelomonocytic leukemia
* 1 & 2 correspond to etiologies 1 & 2
Management:
- cytarabine/daunorubicin (Vyxeos) FDA-approved Aug 2017
Interactions
disease interactions
General
acute myeloid leukemia (AML)
References
- WHO Classification Tumours of Haematopoietic and Lymphoid
Tissues. IARC Press 2001
- Bankhead C.
FDA Approves Fixed Chemo Combo for AML Subtypes.
First approval for treatment- and myelodysplasia-related AML.
MedPage Today. August 03, 2017
https://www.medpagetoday.com/HematologyOncology/Leukemia/67045