Abstract
Treatment-related myelodysplasia (t-MDS) occurs less frequently with the nucleoside analogs than with DNA-damaging agents such as alkylators or topoisomerase II inhibitors. In a chemoimmunotherapy trial conducted between 1997 and 2003 in patients with stage IV indolent lymphoma, 202 patients were treated and 8 have developed MDS between 1 and 5 years after therapy, including 4 who received only fludarabine, mitoxantrone, and dexamethasone (FND) for 6 to 8 courses, with or without rituximab, followed by interferon alpha (IFN-alpha). Complex cytogenetic abnormalities were present in all patients. Abnormalities of chromosome 7 were present in 6 of the 8 patients, 3 of whom received only FND +/- rituximab and IFN-alpha. The abnormalities of chromosome 7 were monosomy 7 in 4 patients (1 of which had add 7p in the remaining chromosome); 1 del 7q; and 1 der 7. MDS with features classically associated with DNA-damaging agents can occur following therapy with FND, with or without rituximab, and IFN-alpha.
Publication types
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Clinical Trial
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Adult
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Aged
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Antibodies, Monoclonal / administration & dosage*
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Agents / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Chromosome Aberrations
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Chromosomes, Human, Pair 7
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Combined Modality Therapy
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DNA Damage
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Dexamethasone / administration & dosage*
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Disease-Free Survival
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Female
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Follow-Up Studies
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Humans
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Immunotherapy / methods
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Interferon-alpha / administration & dosage*
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Leukemia, Myeloid, Acute / chemically induced*
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Leukemia, Myeloid, Acute / diagnosis*
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Lymphoma / drug therapy*
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Male
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Middle Aged
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Mitoxantrone / administration & dosage*
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Monosomy
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Myelodysplastic Syndromes / chemically induced*
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Myelodysplastic Syndromes / diagnosis*
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Remission Induction
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Rituximab
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Time Factors
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Vidarabine / administration & dosage*
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Vidarabine / analogs & derivatives*
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Agents
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Interferon-alpha
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Rituximab
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Dexamethasone
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Mitoxantrone
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Vidarabine
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fludarabine