Mediterranean Journal of Hematology and Infectious Diseases Therapy-related Myeloid Neoplasms I Waldenstrom's Macroglobulinemia

Secondary myelodysplasia (MDS) and acute myeloid leukemia (AML) are frequent long term complications in Chronic Lymphocytic Leukemia (CLL) and Waldenstrom Macroglobulinemia (WM) patients. Although disease role in leukemogen esis there is great concern that therapy may further increase the risk of developing these devastating complications. Nucleoside analogs (NA) and alkylating agents are considered appropriate agents in the treatment of both CLL and WM patients. Prolonged incorporation of these agents or their metabolites into DNA, with potentially mutagenic action, leads to speculation that their therapeutic use might be responsible for an increased incidence of second cancer especially when combined with other DNA damaging agents like alkylating agents. In this review the published studies considering the occurrence of secondary MDS and AML in CLL and WM patients are reported and the potential role of chemotherapeutic agent leukemogenesis is discussed. Introduction: Advances in the treatment of Chronic Lymphocytic Leukemia (CLL) and Waldenstrom Macroglobulinemia (WM) have resulted in higher response rates and more durable remissions. Chemoimmunotherapy has become the standard of care and the addition of rituximab to combination chemotherapy is associated with improved outcomes. As a result, the number of cance r survivors is rapidly growing and the late toxicities of treatment particularly therapy-related myeloid neoplasms (t become a more important concern. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, myelodysplasia (MDS) and acute myeloid leukemia (AML) are frequent long term complications in Chronic Lymphocytic Leukemia (CLL) and Waldenstrom suppression plays a crucial esis there is great concern that therapy may further increase the risk of Nucleoside analogs (NA) and alkylating agents are considered appropriate agents in the treatment immunosuppression related to NA therapy and the incorporation of these agents or their metabolites into DNA, with potentially mutagenic action, leads to speculation that their therapeutic use might be responsible for an increased incidence of especially when combined with other DNA damaging agents like alkylating agents. In this review the published studies considering the occurrence of secondary MDS and AML in CLL and WM patients are reported and the potential role of chemotherapeutic agent s in

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