Secondary acute myeloid leukemia occurring after successful treatment of acute promyelocytic leukemia.

摘要

Secondary neoplasm is one of the most devastating complications of cancer therapy. In patients with acute lym-phoblastic leukemia (AML), the cumulative risk of secondary neoplasia ranges from 1.2 to 3.3% [1]. Secondary acute myeloid leukemia (sAML) occurs in 10-30% of AML cases [2]. sAML has been documented following the treatment of Hodgkin's disease, acute lymphoblastic leukemia, and ovarian and breast cancer. The major causes of sAML are alkylating agents, topoisomerase II inhibitors, and radiotherapy used to treat the primary cancers [3-6]. Patients with acute promyelocytic leukemia (APL) treated with regimens that include trans-retinoic acid (ATRA) have typically achieved long-term disease-free survival [7]. However, recent data show an increase in the rate of secondary neoplasms in these patients [8].