Extended exposure to alkylator chemotherapy: delayed appearance of XXXX .

@entity1 @entity4289 @entity1313 @entity2590 @entity3052 @entity11 @entity2903 @entity2008
OBJECTIVE: A case series of @entity11 treated with alkylator-based chemotherapy who subsequently developed @entity2590 (tMDS) or @entity3052 ( @entity3052 ). BACKGROUND: Alkylator-based chemotherapy is recognized to be leukemogenic; however, it is infrequently described as a delayed consequence of anti- @entity11 treatment. METHODS: Seven @entity1 (4 @entity1 ; 3 @entity1 ) ages 34-69 years (median 44), with @entity11 (3 Grade 2; 4 Grade 3) were treated with surgery, all but one with involved-field radiotherapy and all with alkylator-based chemotherapy ( @entity2903 ; 6 @entity1 , nitrosoureas; 5 @entity1 , both agents; 5 @entity1 ). RESULTS: Exposure to alkylator-based chemotherapy ranged from 8 to 30 months (median 24). The diagnosis of tMDS was determined by bone marrow biopsy in 7 @entity1 . Seven @entity1 showed @entity2008 consistent with chemotherapy induced @entity4289 . Three @entity1 were diagnosed with @entity3052 as well (in two determined by bone marrow and one at autopsy). Interval from last chemotherapy exposure to diagnosis of tMDS/ @entity3052 ranged from 3 to 31 months (median 24 months). Two @entity1 were treated with bone marrow transplantation and 5 received supportive care only. Five @entity1 have died, 2 as a consequence of recurrent @entity1313 , 1 as a complication of transplantation, and 2 due to @entity3052 . CONCLUSIONS: Although rare, induction of tMDS/ @entity3052 following extended use of alkylator-based chemotherapy may become more relevant with the evolving practice to treat @entity11 for protracted periods. Future work to determine at risk @entity1 would be important.
