Leukemogenic potential of adjuvant chemotherapy for early-stage breast cancer : the Eastern Cooperative Oncology Group experience.
Since large numbers of patients with early-stage breast cancer now receive adjuvant chemotherapy containing cyclophosphamide, a known leukemogenic agent, it is important to determine the risk of secondary acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).
Therefore, we identified all cases of AML or MDS developing in patients treated on six clinical adjuvant chemotherapy trials conducted by the Eastern Cooperative Oncology Group.
Of 2,638 patients at risk with 19,200 person-years of follow-up study, three patients developed MDS (two with a characteristic cytogenetic abnormality).
Two patients developed acute leukemia ; however, one had adult T-cell leukemia associated with human T-lymphotrophic virus type 1 and a second patient developed AML after receiving additional cyclophosphamide for metastatic breast cancer.
The estimated incidence rate for MDS is three per 19,200 or 16 per 100,000 person-years of follow-up study with a 95 percent confidence interval of three to 46 per 100,000 person-years.
If all five patients are included, the estimated incidence rate is five per 19,200 or 26 per 100,000 person-years of follow-up study with a 95 percent confidence interval of eight to 61 per 100,000 person-years.
These data suggest that the risk of secondary AML or MDS among patients with early breast cancer who receive standard-dose cyclophosphamide-containing adjuvant chemotherapy is not much higher than in the general population.
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Homme, Cyclophosphamide, Chimiothérapie, Traitement, Leucémie myéloblastique, Myélodysplasique syndrome, Toxicité, Second cancer, Incidence, Epidémiologie, Agent alkylant, Anticancéreux, Aigu, Glande mammaire pathologie, Hémopathie maligne
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Human, Chemotherapy, Treatment, Acute myelocytic leukemia, Myelodysplastic syndrome, Toxicity, Second cancer, Incidence, Epidemiology, Alkylating agent, Antineoplastic agent, Acute, Mammary gland diseases, Malignant hemopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0410269
Code Inist : 002B02U10. Création : 01/03/1996.