{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T17:58:34Z","timestamp":1768327114868,"version":"3.49.0"},"reference-count":0,"publisher":"Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediterr J Hematol Infect Dis"],"abstract":"<jats:p>Treatment for a pre-existing condition using chemotherapy, radiation therapy, immunosuppressive therapy, or a combination of these modalities may lead to the devastating complication of therapy-related myelodysplastic syndrome or acute myeloid leukemia (t-MDS\/t-AML), collectively known as therapy-related myeloid neoplasm (t-MN). This disorder arises as a direct consequence of mutational events induced by the primary treatment.\u00a0 The outcomes for these patients have been historically poor compared to people who develop AML de novo.\u00a0 Currently comprising 10-20% of all cases of AML, t-MN is relatively resistant to conventional leukemia therapies, and is associated with short survival times. Median life expectancy from diagnosis is about 8-10 months in most series. Although the spectrum of cytogenetic abnormalities in t-AML is similar to AML de novo, the frequency of unfavorable cytogenetics, such as a complex karyotype or deletion or loss of chromosomes 5 and\/or 7, is considerably higher in t-MN.\u00a0 Two distinct groups of patients with t-MN have been described. The more common subtype, seen in about 75% of patients, typically occurs 5-7 years after first exposure to alkylating agents or radiation, is often preceded by a myelodysplastic syndrome, and is frequently accompanied by clonal cytogenetic abnormalities such as the loss of all or part of chromosomes 5 or 7. Mutations of the P53 tumor suppressor gene are also common.\u00a0 The risk is related to total cumulative exposure over time to alkylating agents. In contrast, among individuals who develop t-AML after treatment with topoisomerase II inhibitors, the latency period to the development of t-AML is often only 1-3 years, antecedent MDS is rare, and gene rearrangements involving MLL at 11q23 or RUNX1\/AML1 at 21q22 are common. It is now well recognized that acute promyelocytic leukemia (APL) and other subtypes of AML with balanced translocations sometimes occur as a t-MN in patients who have previously received cytotoxic therapy or ionizing radiation therapy. In general, t-MN patients should be encouraged to participate in prospective clinical trials that are appropriately designed for other AML patients with similar cytogenetic abnormalities.\u00a0 Patients who have an HLA-matched donor should be considered for allogeneic hematopoietic cell transplantation, although patients with favorable karyotypes such as t(15;17) and inv(16) may do well with conventional intensive chemotherapy.\u00a0 This review will focus on these \u201cgood risk\u201d therapy-related leukemias, i.e. those with APL or inv(16)\/t(16;16) or t(8;21).<\/jats:p>","DOI":"10.4084\/mjhid.2011.032","type":"journal-article","created":{"date-parts":[[2011,7,8]],"date-time":"2011-07-08T15:40:22Z","timestamp":1310139622000},"page":"e2011032","source":"Crossref","is-referenced-by-count":21,"title":["PROGNOSIS AND THERAPY WHEN ACUTE PROMYELOCYTIC LEUKEMIA AND OTHER \u201cGOOD RISK\u201d ACUTE MYELOID LEUKEMIAS OCCUR AS A THERAPY-RELATED MYELOID NEOPLASM"],"prefix":"10.4084","volume":"3","author":[{"given":"Richard A.","family":"Larson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Le Beau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2554","published-online":{"date-parts":[[2011,7,8]]},"container-title":["Mediterranean Journal of Hematology and Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/2011.032\/361","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/2011.032\/362","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/2011.032\/361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T11:15:52Z","timestamp":1768302952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/view\/2011.032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7,8]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2011,1,3]]}},"URL":"https:\/\/doi.org\/10.4084\/mjhid.2011.032","relation":{},"ISSN":["2035-3006"],"issn-type":[{"value":"2035-3006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7,8]]}}}