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 Blood, 15 June 2005, Vol. 105, No. 12, pp. 4573-4575.
Prepublished online as a Blood First Edition Paper on March 1, 2005; DOI 10.1182/blood-2004-08-3035.

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CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

Myelodysplasia and acute myeloid leukemia following therapy for indolent lymphoma with fludarabine, mitoxantrone, and dexamethasone (FND) plus rituximab and interferon alpha

Peter McLaughlin, Elihu Estey, Armand Glassman, Jorge Romaguera, Felipe Samaniego, Ana Ayala, Kimberly Hayes, Anne Marie Maddox, H. Alejandro Preti, and Fredrick B. Hagemeister

From the Departments of Lymphoma/Myeloma, Leukemia, Hematopathology, and Laboratory Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX; and University of Arkansas Medical School, Little Rock, AR.

Treatment-related myelodysplasia (t-MDS) occurs less frequently with the nucleoside analogs than with DNA-damaging agents such as alkylators or topoisomerase II inhibitors. In a chemoimmunotherapy trial conducted between 1997 and 2003 in patients with stage IV indolent lymphoma, 202 patients were treated and 8 have developed MDS between 1 and 5 years after therapy, including 4 who received only fludarabine, mitoxantrone, and dexamethasone (FND) for 6 to 8 courses, with or without rituximab, followed by interferon alpha (IFN-{alpha}). Complex cytogenetic abnormalities were present in all patients. Abnormalities of chromosome 7 were present in 6 of the 8 patients, 3 of whom received only FND ± rituximab and IFN-{alpha}. The abnormalities of chromosome 7 were monosomy 7 in 4 patients (1 of which had add 7p in the remaining chromosome); 1 del 7q; and 1 der 7. MDS with features classically associated with DNA-damaging agents can occur following therapy with FND, with or without rituximab, and IFN-{alpha}. (Blood. 2005;105:4573-4575)


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Related Article in Blood Online:

Flu redux and RIT: friendly fire in the treatment of low-grade lymphoma
Leo I. Gordon
Blood 2005 105: 4543-4544. [Full Text] [PDF]



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