Abstract
Therapy-related leukemia and myelodysplastic syndrome (t-Leuk/MDS) are mainly caused by topoisomerase II inhibitors that cause acute myeloid leukemia (AML) with an 11q23 translocation or by alkylating agents that induce MDS/AML with an AML1 mutation and monosomy 7.1, 2 Two types of t-Leuk/MDS can be distinguished, one of which has a long latency (5–7 years) and is seen following alkylating agents, frequently with an preleukemic phase.1 The other has a short latency period (1–3 years), no preleukemic phase, and is strongly associated with the administration of topoisomerase II inhibitors and chromosomal abnormalities involving 11q23 translocation/MLL rearrangement (MLL-R).2 Repair of etoposide (VP-16)-stabilized DNA topoisomerase II covalent complexes may initiate MLL-R observed in patients.3
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