Abstract
17506 Background: Therapy-related AML (t-AML) has been reported in ovarian cancer patients treated with chemotherapy and has been associated with the use of platinum. However, little is known about these patients’ clinical characteristics, cytogenetic changes, clinical course or treatment outcome. Methods: Roswell Park Cancer Institute patients with diagnoses of AML or MDS by French-American- British (FAB) Group or World Health Organization criteria following a diagnosis of ovarian cancer were retrospectively reviewed. Results: Ten patients were identified between 1990 and 2006. All 10 had received platinum chemotherapy, and 8 (80%) had also received taxanes, 4 (40%) cyclophosphamide and 3 (30%) adriamycin. The median age at ovarian cancer diagnosis was 56 (range, 49–78) years, and the median age at AML/MDS diagnosis was 62 (range, 56–81) years. The median interval from diagnosis of ovarian cancer to AML/MDS was 5.5 (range, 3–11) years, while the median survival time of 395 ovarian cancer patients treated at RPCI between 1982 and 1998 was 4.1 years (range, 1 month to 23 years). Eight patients had AML and 2 had MDS. AML FAB types were M2 in 3, M0 and M4 in 2 each, and M6 in 1. Among 9 patients with cytogenetic data available, 6 had complex karyotypes, all of which included monosomy 5 or del(5q), and three had single clonal abnormalities, all involving chromosome 7. Of 7 AML patients who received induction chemotherapy, only 3 achieved complete remissions, and remissions were brief (3, 4.5 and 5 months). Median overall survival for all ten patients after diagnosis of AML or MDS was 4 months (range, 0.5 months to 9.5 months). Conclusions: Patients with t-AML/t-MDS following therapy for ovarian cancer have unfavorable cytogenetic abnormalities, including complex karyotypes and involvement of chromosomes 5 and 7, which are typical findings following alkylating agent therapy, and these patients have a very poor prognosis. No significant financial relationships to disclose.
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