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Titolo:
Biology and therapy of secondary leukaemias
Autore:
Dann, EJ; Rowe, JM;
Indirizzi:
Technion Israel Inst Technol, Rambam Med Ctr, Dept Hematol & Bone Marrow Transplantat, IL-31096 Haifa, Israel Technion Israel Inst Technol Haifa Israel IL-31096 L-31096 Haifa, Israel Technion Israel Inst Technol, Bruce Rappaport Fac Med, IL-31096 Haifa, Israel Technion Israel Inst Technol Haifa Israel IL-31096 L-31096 Haifa, Israel
Titolo Testata:
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
fascicolo: 1, volume: 14, anno: 2001,
pagine: 119 - 137
SICI:
1521-6926(200103)14:1<119:BATOSL>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOID-LEUKEMIA; BONE-MARROW-TRANSPLANTATION; ACUTE NONLYMPHOCYTIC LEUKEMIA; ACUTE MYELOGENOUS LEUKEMIA; NON-HODGKINS-LYMPHOMA; STEM-CELL TRANSPLANTATION; FAVORABLE CYTOGENETIC ABNORMALITIES; HEMATOPOIETIC GROWTH-FACTORS; TOPOISOMERASE-II INHIBITORS; COLONY-STIMULATING FACTOR;
Keywords:
secondary leukaemia; therapy-related leukaemia; leukaemia in elderly; t-AML;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
101
Recensione:
Indirizzi per estratti:
Indirizzo: Dann, EJ Technion Israel Inst Technol, Rambam Med Ctr, Dept Hematol & BoneMarrow Transplantat, IL-31096 Haifa, Israel Technion Israel Inst Technol Haifa Israel IL-31096 aifa, Israel
Citazione:
E.J. Dann e J.M. Rowe, "Biology and therapy of secondary leukaemias", BEST P R C, 14(1), 2001, pp. 119-137

Abstract

Secondary leukaemias are common, accounting for more than 40% of all patients with acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS). Aclinical history of exposure to haematotoxins or radiation is helpful; however, many older patients are diagnosed with leukaemia with no antecedent history of exposure. These patients' disease show a remarkably similar phenotype to classic therapy-related leukaemia. The specific cytogenetic abnormalities common to MDS, alkylating-agent-related AML and poor-prognosis AML (3q-, -5, 5q-, -7, 7q-, +8, +9, 11q-, 12p-, -18, -19,20q-, +21, t(1;7), t(2;11)), probably reflect a common pathogenesis distinct from that of other denovo AMLs, although the pathogenetic pathway has yet to be elucidated. Possibly, tumour suppressor genes are implicated and genomic instability may be a cause of multiple unbalanced chromosomal translocations or deletions. Typically, these patients are either elderly or have a history of exposure to alkylating agents or environmental exposure 5-7 years prior to diagnosis. Another distinct entity affects the mixed lineage leukaemia (MLL) gene located on 11q23. These account for about 3% of patients with therapy-related leukaemia and have a short latency period from exposure, usually to an inhibitor of topoisomerase II. Other therapy-related patients with t(8:21), invl6 or t( 15;17) translocations should be treated as any other de novo AML with similar cytogenetics. In summary, the major prognostic factor is related to the pathogenetic mechanisms of the leukaemia. Cytogenetics and molecular features are a better predictor of outcome than patient history. Patients should receive standard induction therapy. However, the long-term outcomeis relatively poor; the best results being obtained among patients undergoing allogeneic transplantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/10/20 alle ore 10:51:09