Title

Incidence of Therapy-Related Myeloid Neoplasia After Initial Therapy for Chronic Lymphocytic Leukemia With Fludarabine-Cyclophosphamide Versus Fludarabine: Long-Term Follow-up of Us Intergroup Study E2997

Document Type

Article

Publication Date

2011

Digital Object Identifier (DOI)

https://doi.org/10.1182/blood-2011-03-342485

Abstract

Chemotherapy-related myeloid neoplasia (t-MN) is a significant late toxicity concern after cancer therapy. In the randomized intergroup phase 3 E2997 trial, initial therapy of chronic lymphocytic leukemia with fludarabine plus cyclophosphamide (FC) compared with fludarabine alone yielded higher complete and overall response rates and longer progression-free, but not overall, survival. Here, we report t-MN incidence in 278 patients enrolled in E2997 with a median 6.4-year follow-up. Thirteen cases (4.7%) of t-MN occurred at a median of 5 years from initial therapy for chronic lymphocytic leukemia, 9 after FC and 4 after fludarabine alone. By cumulative incidence methodology, rates of t-MN at 7 years were 8.2% after FC and 4.6% after fludarabine alone (P = .09). Seven of the 9 cases of t-MN after FC occurred without additional therapy. Abnormalities involving chromosomes 5 or 7 were found in 10 cases, which suggests alkylator involvement. These data suggest that FC may induce more t-MN than fludarabine alone.

Was this content written or created while at USF?

Yes

Citation / Publisher Attribution

Blood, v. 118, issue 13, p. 3525-3527

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