Therapy-related myelodysplasia and acute myeloid leukemia after Ewing sarcoma and primitive neuroectodermal tumor of bone: A report from the Children's Oncology Group. 2007

Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
Division of Pediatric Oncology, City of Hope National Medical Center, Duarte, CA, USA. sbhatia@coh.org

This study describes the magnitude of risk of therapy-related myelodysplasia and acute myeloid leukemia (t-MDS/AML) in 578 individuals diagnosed with Ewing sarcoma and enrolled on Children's Oncology Group therapeutic protocol, INT-0091. Between 1988 and 1992, patients with or without metastatic disease were randomized to receive doxorubicin, vincristine, cyclophosphamide, and dactinomycin (regimen A) or these 4 drugs alternating with etoposide and ifosfamide (regimen B). Between 1992 and 1994, patients with metastatic disease were nonrandomly assigned to receive high-intensity therapy (regimen C: regimen B therapy with higher doses of doxorubicin, cyclophosphamide, and ifosfamide). Median age at diagnosis of Ewing sarcoma was 12 years, and median length of follow-up, 8 years. Eleven patients developed t-MDS/AML, resulting in a cumulative incidence of 2% at 5 years. While patients treated on regimens A and B were at a low risk for development of t-MDS/AML (cumulative incidence: 0.4% and 0.9% at 5 years, respectively), patients treated on regimen C were at a 16-fold increased risk of developing t-MDS/AML (cumulative incidence: 11% at 5 years), when compared with those treated on regimen A. Increasing exposure to ifosfamide from 90 to 140 g/m2, cyclophosphamide from 9.6 to 17.6 g/m2, and doxorubicin from 375 to 450 mg/m2 increased the risk of t-MDS/AML significantly.

UI MeSH Term Description Entries
D007069 Ifosfamide Positional isomer of CYCLOPHOSPHAMIDE which is active as an alkylating agent and an immunosuppressive agent. Isofosfamide,Isophosphamide,Asta Z 4942,Holoxan,Iphosphamide,Iso-Endoxan,NSC-109,724,NSC-109724,Iso Endoxan,NSC 109,724,NSC 109724,NSC109,724,NSC109724
D007223 Infant A child between 1 and 23 months of age. Infants
D007951 Leukemia, Myeloid Form of leukemia characterized by an uncontrolled proliferation of the myeloid lineage and their precursors (MYELOID PROGENITOR CELLS) in the bone marrow and other sites. Granulocytic Leukemia,Leukemia, Granulocytic,Leukemia, Myelocytic,Leukemia, Myelogenous,Myelocytic Leukemia,Myelogenous Leukemia,Myeloid Leukemia,Leukemia, Monocytic, Chronic,Monocytic Leukemia, Chronic,Chronic Monocytic Leukemia,Chronic Monocytic Leukemias,Granulocytic Leukemias,Leukemia, Chronic Monocytic,Leukemias, Chronic Monocytic,Leukemias, Granulocytic,Leukemias, Myelocytic,Leukemias, Myelogenous,Leukemias, Myeloid,Monocytic Leukemias, Chronic,Myelocytic Leukemias,Myelogenous Leukemias,Myeloid Leukemias
D008297 Male Males
D009436 Neural Tube Defects Congenital malformations of the central nervous system and adjacent structures related to defective neural tube closure during the first trimester of pregnancy generally occurring between days 18-29 of gestation. Ectodermal and mesodermal malformations (mainly involving the skull and vertebrae) may occur as a result of defects of neural tube closure. (From Joynt, Clinical Neurology, 1992, Ch55, pp31-41) Craniorachischisis,Developmental Defects, Neural Tube,Diastematomyelia,Exencephaly,Neurenteric Cyst,Spinal Cord Myelodysplasia,Tethered Cord Syndrome,Acrania,Developmental Neural Tube Defects,Iniencephaly,Neural Tube Developmental Defects,Neuroenteric Cyst,Occult Spinal Dysraphism,Occult Spinal Dysraphism Sequence,Tethered Spinal Cord Syndrome,Acranias,Craniorachischises,Cyst, Neurenteric,Cyst, Neuroenteric,Cysts, Neurenteric,Cysts, Neuroenteric,Defect, Neural Tube,Defects, Neural Tube,Diastematomyelias,Dysraphism, Occult Spinal,Dysraphisms, Occult Spinal,Exencephalies,Iniencephalies,Myelodysplasia, Spinal Cord,Myelodysplasias, Spinal Cord,Neural Tube Defect,Neurenteric Cysts,Neuroenteric Cysts,Occult Spinal Dysraphisms,Spinal Cord Myelodysplasias,Spinal Dysraphism, Occult,Spinal Dysraphisms, Occult,Tethered Cord Syndromes
D001859 Bone Neoplasms Tumors or cancer located in bone tissue or specific BONES. Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003520 Cyclophosphamide Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the LIVER to form the active aldophosphamide. It has been used in the treatment of LYMPHOMA and LEUKEMIA. Its side effect, ALOPECIA, has been used for defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. (+,-)-2-(bis(2-Chloroethyl)amino)tetrahydro-2H-1,3,2-oxazaphosphorine 2-Oxide Monohydrate,B-518,Cyclophosphamide Anhydrous,Cyclophosphamide Monohydrate,Cyclophosphamide, (R)-Isomer,Cyclophosphamide, (S)-Isomer,Cyclophosphane,Cytophosphan,Cytophosphane,Cytoxan,Endoxan,NSC-26271,Neosar,Procytox,Sendoxan,B 518,B518,NSC 26271,NSC26271
D003609 Dactinomycin A compound composed of a two CYCLIC PEPTIDES attached to a phenoxazine that is derived from STREPTOMYCES parvullus. It binds to DNA and inhibits RNA synthesis (transcription), with chain elongation more sensitive than initiation, termination, or release. As a result of impaired mRNA production, protein synthesis also declines after dactinomycin therapy. (From AMA Drug Evaluations Annual, 1993, p2015) Actinomycin,Actinomycin D,Meractinomycin,Cosmegen,Cosmegen Lyovac,Lyovac-Cosmegen,Lyovac Cosmegen,Lyovac, Cosmegen,LyovacCosmegen

Related Publications

Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
December 2007, Pediatric blood & cancer,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
February 2007, Ear, nose, & throat journal,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
March 2011, Oncology letters,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
January 2012, Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
January 2005, Acta otorrinolaringologica espanola,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
July 2012, Archives of pathology & laboratory medicine,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
February 2021, The Journal of international medical research,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
January 2022, Ochsner journal,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
September 2021, Annals of laboratory medicine,
Smita Bhatia, and Mark D Krailo, and Zhengjia Chen, and Laura Burden, and Frederic B Askin, and Paul S Dickman, and Holcombe E Grier, and Michael P Link, and Paul A Meyers, and Elizabeth J Perlman, and Aaron R Rausen, and Leslie L Robison, and Teresa J Vietti, and James S Miser
September 2020, Autopsy & case reports,
Copied contents to your clipboard!