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In contrast, treatment with alkylating agents has been associated with a longer latency, an initial MDS phase, adverse cytogenetics, and a poor prognosis. The pathogenesis of t-MN can be explained by direct induction of an oncogene through chromosomal translocations, induction of genetic instability, or selection of a preexisting treatment-resistant hematopoietic stem cell clone. Recent evidence has highlighted the importance of the last mechanism and explains the high frequency of TP53 mutations in patients with t-MN. After previous cytotoxic therapy, patients present with specific vulnerabilities, especially evident from the high nonrelapse mortality in patients with t-MN after allogeneic hematopoietic cell transplantation. Here, the prognostic impact of currently known risk factors and the therapeutic options in different patient subgroups will be discussed.<\/jats:p>","DOI":"10.1182\/asheducation-2016.1.24","type":"journal-article","created":{"date-parts":[[2016,12,2]],"date-time":"2016-12-02T11:05:27Z","timestamp":1480676727000},"page":"24-32","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":21,"title":["Therapy-related myeloid neoplasms: does knowing the origin help to guide treatment?"],"prefix":"10.1182","volume":"2016","author":[{"given":"Michael","family":"Heuser","sequence":"first","affiliation":[{"name":"Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"20","key":"2019111521261178900_B1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization 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