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Therapy-related Myelodysplastic Syndrome Following Primary Breast Cancer.

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journal contribution
posted on 20.09.2017 by Malmgren JA, Calip GS, Pyott SM, Atwood MK, Kaplan HG
BACKGROUND: Therapy-related myelodysplastic syndrome (t-MDS) is a serious clinical disease occurring after breast cancer treatment. METHODS: A cohort of 11,684 invasive breast cancer (BC) patients from 1990-2014 were followed for incidence of t-MDS through institutional and the Surveillance, Epidemiology and End Results (SEER) Program registries. t-MDS cases were identified using ICD-O SEER registry codes, pathology and chart reports. Treatment, cytogenetics, and time from BC diagnosis to t-MDS and t-MDS diagnosis to last follow up or death were obtained. Incidence rate ratios were calculated using SEER national incidence rates for comparison. RESULTS: 27 cases of t-MDS post BC treatment were confirmed. 96% of cases were breast cancer stage I-II at diagnosis. All patients had received radiation treatment and 59% received adjuvant chemotherapy. Two patients were alive with no evidence of disease after treatment with stem cell transplantation (age 33 and 46). t-MDS incidence was 30 times the expected population rate among patients <55 years (RR 31.8, 95% CI 15.0, 60.8) with shorter time from t-MDS diagnosis to death (median survival time: <55: 8 months, 55-74: 26 months, 75+: 23 months). CONCLUSION: We found elevated t-MDS risk especially among younger BC patients with stem cell transplantation the only observed curative treatment.

Funding

This research was supported by the Kaplan Cancer Research Fund and the Cancer Surveillance System at the Fred Hutchinson Cancer Research Center.

History

Publisher Statement

This is the author’s version of a work that was accepted for publication in Leukemia Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Leukemia Research. 2016. 47: 178-184. doi: 10.1016/j.leukres.2016.06.005.

Publisher

Elsevier

issn

0145-2126

Issue date

01/08/2016

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