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Therapy-related myelodysplastic syndrome and acute myeloid leukemia in
children: correlation between chromosomal abnormalities and prior therapy
CM Rubin, DC Arthur, WG Woods, BJ Lange, PC Nowell, JD Rowley, J Nachman, B Bostrom, ES Baum and CR Suarez
Department of Pediatrics, University of Chicago, IL.
We have studied 20 children with therapy-related myelodysplastic syndrome
(MDS) or acute myeloid leukemia (AML) who were 3 months to 16 years old at
diagnosis of their primary neoplasm and 1 to 24 years old at diagnosis of
their secondary neoplasm. The median interval from initial treatment for
the first malignancy to diagnosis of therapy- related MDS or AML was 46
months (range, 12 to 116 months). Twelve patients had chromosomal
abnormalities resulting in loss of material from the long arm of
chromosomes 5 and/or 7, three patients had abnormalities of chromosome 11
band q23, one patient had both classes of abnormalities, three patients had
other abnormalities, and one patient had a normal karyotype. Ten of 12
patients with chromosome 5 and/or 7 abnormalities had been exposed to an
alkylating agent, and two of three patients with 11q23 abnormalities had
been exposed to an epipodophyllotoxin. The patient with both classes of
abnormalities had been exposed to both types of therapy. We conclude that
abnormalities of chromosomes 5 and/or 7 are common in children with
therapy-related MDS or AML. The proposed relationships between exposure to
alkylating agents and abnormalities of chromosomes 5 and/or 7 and between
exposure to epipodophyllotoxins and abnormalities of 11q23 are supported in
this pediatric series.
Volume 78,
Issue 11,
pp. 2982-2988,
12/01/1991
Copyright © 1991 by The American Society of Hematology
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