Table 1.
Magnitude of Risk and Populations at Increased Risk of Therapy-related Leukemia
| Study | Study design | Sample size/ number of SMNs |
Primary Diagnoses Type of HCT |
Magnitude of Risk and Risk Factors |
|---|---|---|---|---|
| t-MDS/AML after autologous Hematopoeitic cell Transplantation | ||||
| Krishnan A et al. Blood. 2000;95:1588- 1593106 |
Retrospective cohort study Nested case- control study |
612/22 MDS/AML |
Hodgkin lymphoma Non-Hodgkin lymphoma Autologous HCT |
Cumulative probability of MDS/AM L : 8.6% at 6 years Stem cell priming with VP- 16, pre-HCT radiation associated with increased risk of t-MDS/AML |
| Milligan DW et al. Br J Haematol. 1999;106:1020- 1026107 |
Retrospective cohort design |
4,998/ 66 MDS/AML |
Hodgkin lymphoma Non-Hodgkin lymphoma Autologous HCT |
5-year cumulative probability was 4.6% for HL and 3% for NHL. Older age at HCT, diagnosis of HL, exposure to TBI, multiple HCT, years between diagnosis were associated with increased risk of MDS/AML |
| Bhatia S, et al. Blood 1996;87:3633-910 |
Retrospective cohort design |
258/ 10 MDS/AML |
Hematologic malignancies Autologous HCT |
6-year cumulative probability was 13.5%. Peripheral blood stem cell transplantation Age >35 years at autologous hematopoietic cell transplantation |
| Friedberg JW, et al. J Clin Oncol 1999;17;3128-3592 |
Retrospective cohort design |
552/41 | Non-Hodgkin lymphoma | Fewer number of cells infused |
| t-MDS/AML after conventional therapy | ||||
| Koontz MZ et al. J Clin Oncol 2013;31:592-8108 |
Retrospective cohort design |
754/24 | Hodgkin lymphoma | 10-year cumulative incidence ranged from 0.3% to 5.7%. Cumulative alkylating agent exposure increased the risk |
| Bhatia S et al. N Engl J Med 1996;334:745- 513 |
Retrospective Cohort design |
1380/26 | Hodgkin lymphoma | 14-year cumulative probability was 2.8% Treatment with alkylating agents, age at diagnosis at 10 to 16 years (c/w <10 years), recurrence of primary disease risk, and a late stage of disease at diagnosis were associated with an increased |
| Bhatia S, et al. Blood 2002;99:4257-647 |
Retrospective cohort design |
8831/14 | Acute lymphoblastic leukemia |
15-years cumulative incidence was 0.3%; relapse of primary disease was associated with increased risk |
| Bhatia S et al. Blood 2007;109:46-516 |
Retrospective cohort study design |
578/11 | Ewing sarcoma | 5-year cumulative incidence of 2%; increasing exposure from 90 g/m2 to 140 g/m2; cyclophosphamide from 9.6 to 17.6 g/m2 and doxorubicin from 375 to 450 mg/m2 increased the risk |
| Travis LB et al. N Engl J Med. 1999;340:351-79 |
Case-control study design |
Cases: 96/ controls: 272 |
Ovarian cancer | Relative risk for treatment with carboplatin and cisplatin increased the risk in a dose-dependent fashion |
| Travis LB et al. J Natl Cancer Inst 2000;92:1165-718 |
Case-control study design |
Cases: 36; controls: 106 |
Testicular cancer | Radiation to active bone marrow (dose-dependent relation); cumulative dose of cisplatin |