Fall 2011

These publications highlight recent findings in t-AML by researchers around the world:

[The World Health Organization (WHO) uses the term ‘therapy-related myeloid neoplasms’ (t-MN) to cover a spectrum of therapy-related disorders: Acute myeloid leukemia (t-AML); Myelodysplastic syndromes (t-MDS); and Myelodysplastic/myeloproliferative neoplasms (t-MDS/MPN).]

t-AML Diagnosis and Incidence

  • t-MDS/t-AML is a rare but lethal event in patients diagnosed with epithelial ovarian carcinoma. Vay et al. conducted an epidemiological analysis of patients diagnosed with epithelial ovarian carcinoma (EOC) to understand the risks of secondary leukemia following treatment.  To date, no large series have been conducted to evaluate patient characteristics and outcomes associated with t-MDS/t-AML in these patients.  Among 63,520 patients diagnosed with EOC in the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, 199 secondary myeloid leukemia cases were identified (overall incidence rate of 0.17%) with a median survival of 3 months.  Advanced age at ovarian cancer diagnosis and surgical treatment were significant risk factors.  However, the incidence of t-MDS/t-AML has decreased since the use of platinum/taxane-based therapies became the standard of care.  (Vay et al.  Therapy-related myeloid leukemia after treatment for epithelial ovarian carcinoma: An epidemiological analysis. Gynecol Oncol 123:456-60, 2011.)

Genetic Abnormalities in t-AML

  • Dysfunctions in metabolic pathways are associated with t-MDS/t-AML development. Metabolomics, the characterization of small molecule metabolites generated from cellular processes, is emerging as an important discipline for discovering new biomarkers for disease.  Cano et al. performed an NMR-based metabolomic analysis of peripheral blood stem cell samples from 12 patients prior to autologous hematopoietic cell transplantation for Hodgkin lymphoma or non-Hodgkin lymphoma.  Of these patients, 6 subsequently developed t-MDS/t-AML.  The analysis suggested that patients with t-MDS/t-AML had dysfunctions in alanine and aspartate metabolism, glyoxylate and dicarboxylate metabolism, the citrate acid cycle, and aminoacyl-t-RNA biosynthesis.  These dysfunctions may act as predisposing factors for the development of t-MDS/t-AML.  (Cano et al.  NMR-based metabolomic analysis of the molecular pathogenesis of therapy-related myelodysplasia/acute myeloid leukemia. J Proteome Res 10: 2873-2881, 2011.)

t-AML Treatment and Outcomes