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Myelodysplastic Syndrome/AML Risk Increased After Chemo

Since 2000, risks for therapy-related myelodysplastic syndrome, AML up after chemo for solid cancers

FRIDAY, Jan. 4, 2019 (HealthDay News) — The risks for therapy-related myelodysplastic syndrome or acute myeloid leukemia (tMDS/AML) are elevated after chemotherapy use for solid tumors, according to a study published online Dec. 20 in JAMA Oncology.

Lindsay M. Morton, Ph.D., from the National Cancer Institute in Bethesda, Maryland, and colleagues quantified tMDS/AML risk after chemotherapy for solid cancers since 2000. Risk patterns were correlated with chemotherapy treatment practices for 1,619 tMDS/AML cases among 700,612 adults who were diagnosed during 2000 to 2013 with first primary solid tumor cancer, received initial chemotherapy, and survived one year or longer.

The researchers found that for 22 of 23 solid cancers, tMDS/AML risks were significantly elevated after chemotherapy; relative risks varied from 1.5 to >10, and the excess absolute risks ranged from 1.4 to >15 cases per 10,000 person-years relative to the general population. After tMDS/AML diagnosis, overall survival was poor (78.4 percent died; median overall survival, seven months). About three-quarters of tMDS/AML cases expected to occur within the next five years will be due to chemotherapy among patients currently treated with chemotherapy, according to the researchers. There was a substantial increase in use of known leukemogenic agents, particularly platinum compounds, in initial chemotherapy since 2000, according to Surveillance, Epidemiology, and End Results data linked with Medicare claims for 165,821 seniors.

“Treatment risk and benefit assessments should balance tMDS/AML risks and other chemotherapy-related adverse effects against potential gains in survival, particularly for patients with a favorable prognosis,” the authors write.

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