BACKGROUND: Acute lymphoblastic leukemia (ALL) occurring in patients with a history of prior chemotherapy/radiotherapy exposure has been previously reported to be rare, accounting for <2.5% of ALL cases. METHODS: All cases of adult ALL with a history of prior cytotoxic or radiation therapy at a leukemia referral center over a 13-year period were analyzed. RESULTS: Twenty-three cases, representing 6.9% of all ALL cases, were identified. Of these, 17 (74%) had at least 1 high-risk feature; 8 (35%) had MLL rearrangements, and 4 were BCR-ABL(+) . MLL rearrangements were correlated with CD15 expression and absence of CD10, and also tended to have a shorter mean latency period and more prior topoisomerase II exposure. Twenty-one patients received induction therapy, and 18 (86%) achieved a complete response, 17 with 1 induction. Six patients have relapsed and died, and 4 others died of other complications, 2 of these postallogeneic stem cell transplantation. Median disease-free survival (DFS) and overall survival (OS) were 27 and 13.6 months, respectively, and 3-year DFS and OS were 37.1% and 37.6%, respectively. CONCLUSIONS: The frequency of therapy-related ALL is higher than previously reported and has a poor prognosis, probably related to the high frequency of adverse risk features.
BACKGROUND:Acute lymphoblastic leukemia (ALL) occurring in patients with a history of prior chemotherapy/radiotherapy exposure has been previously reported to be rare, accounting for <2.5% of ALL cases. METHODS: All cases of adult ALL with a history of prior cytotoxic or radiation therapy at a leukemia referral center over a 13-year period were analyzed. RESULTS: Twenty-three cases, representing 6.9% of all ALL cases, were identified. Of these, 17 (74%) had at least 1 high-risk feature; 8 (35%) had MLL rearrangements, and 4 were BCR-ABL(+) . MLL rearrangements were correlated with CD15 expression and absence of CD10, and also tended to have a shorter mean latency period and more prior topoisomerase II exposure. Twenty-one patients received induction therapy, and 18 (86%) achieved a complete response, 17 with 1 induction. Six patients have relapsed and died, and 4 others died of other complications, 2 of these postallogeneic stem cell transplantation. Median disease-free survival (DFS) and overall survival (OS) were 27 and 13.6 months, respectively, and 3-year DFS and OS were 37.1% and 37.6%, respectively. CONCLUSIONS: The frequency of therapy-related ALL is higher than previously reported and has a poor prognosis, probably related to the high frequency of adverse risk features.
Authors: Francesca Ferraro; Feng Gao; Keith Stockerl-Goldstein; Peter Westervelt; John F DiPersio; Armin Ghobadi Journal: Leuk Res Date: 2018-07-31 Impact factor: 3.156
Authors: Jane E Churpek; Rafael Marquez; Barbara Neistadt; Kimberly Claussen; Ming K Lee; Matthew M Churpek; Dezheng Huo; Howard Weiner; Mekhala Bannerjee; Lucy A Godley; Michelle M Le Beau; Colin C Pritchard; Tom Walsh; Mary-Claire King; Olufunmilayo I Olopade; Richard A Larson Journal: Cancer Date: 2015-12-07 Impact factor: 6.860
Authors: Caner Saygin; Ashwin Kishtagari; Ryan D Cassaday; Natalie Reizine; Ilana Yurkiewicz; Michaela Liedtke; Wendy Stock; Richard A Larson; Ross L Levine; Martin S Tallman; Jae H Park; Cassandra Kerr; Bartlomiej Przychodzen; Mikkael A Sekeres; Matt E Kalaycio; Hetty E Carraway; Betty K Hamilton; Ronald Sobecks; Aaron Gerds; Sudipto Mukherjee; Aziz Nazha; Jaroslaw P Maciejewski; Anjali S Advani Journal: Blood Adv Date: 2019-12-23
Authors: Michael Goodman; Judy S LaKind; Jerald A Fagliano; Timothy L Lash; Joseph L Wiemels; Deborah M Winn; Chirag Patel; Juliet Van Eenwyk; Betsy A Kohler; Enrique F Schisterman; Paul Albert; Donald R Mattison Journal: Int J Environ Res Public Health Date: 2014-01-28 Impact factor: 3.390