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Abstract
Therapy - related myelodysplastic syndromes/acute myeloid leukemia (t-MDS/AML) are now considered a single entity, called therapy - related myeloid neoplasms base on the current World Health Organization classification. T-MDS/t-AML is a complication of primary malignancies including solid tumors and/or hematological neoplasms and/or non-hematological neoplasms (systemic lupus erythematosus,...) after exposure to chemotherapeutic drugs and/or radiation and/or immunosuppressant drugs. T-AML accounts for approximately 10-20% of total AML cases. Those diseases can be: Hodgkin Lymphoma, non-Hodgkin Lymphoma, acute lymphoblastic leukemia (ALL), sarcoma, ovarian and testicular cancer, autologous hematopoietic stem cell transplantation (HSCT). Several thousand autotransplants are performed each year for patients with relapsed lymphoma. Estimates of the incidence of therapy-related leukemia among these lymphoma and Hodgkin disease patients range between 1-14% at 3-15 years. The risk appears lower in patients undergoing autologous HSCT for breast cancer and myeloma. Important risk factors include age, extent of prior therapy, and exposure to certain agents before and during the transplant procedure. The current standard protocols for autologous HSCT include drugs that are known to be leukemogenic. In particular, alkylating agents (AAs) and topoisomerase II inhibitors (TIs) are associated with an increased risk for development of t-MDS/AML. They damage to normal hematopoietic stem cells and immune cells, leading to genetic mutations. The increased use of allogeneic HSCT with reducedintensity conditioning (RIC) regimens could improve outcomes for lymphoma patients who received higher dose of chemotherapy because of the lower toxicity of RIC regimens compared to standard myeloablative conditioning regimens.
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| Published | 05-01-2025 | |
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| Issue | No. 67 (2021) | |
| Section | Review | |
| DOI | 10.38103/jcmhch.2021.67.2 | |
| Keywords | t-MDS/AML, ghép tế bào gốc tạo máu, u lympho t-MDS/AML, hematopoietic stem cell transplantation, lymphoma |
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