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Blood, 15 March 2002, Vol. 99, No. 6, pp. 1909-1912

PERSPECTIVE

Genetic pathways in therapy-related myelodysplasia and acute myeloid leukemia

Jens Pedersen-Bjergaard, Mette K. Andersen, Debes H. Christiansen, and Claus Nerlov

From the Cytogenetic Laboratory, Section of Hematology/Oncology, Department of Clinical Genetics, the Juliane Marie Center and the Laboratory of Gene Therapy Research, the Laboratory Center, Rigshospitalet, University Hospital of Copenhagen, Denmark.

Therapy-related acute myeloid leukemia (t-AML) in most cases develops after chemotherapy of other malignancies and shows characteristic chromosome aberrations. Two general types of t-AML have previously been identified. One type is observed after therapy with alkylating agents and characteristically presents as therapy-related myelodysplasia with deletions or loss of the long arms of chromosomes 5 and 7 or loss of the whole chromosomes. The other type is observed after therapy with topoisomerase II inhibitors and characteristically presents as overt t-AML with recurrent balanced chromosome aberrations. Recent research suggests that these 2 general types of t-AML can now be subdivided into at least 8 genetic pathways with a different etiology and different biologic characteristics.


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