Leukemias and myelodysplastic syndromes secondary to drug, radiation, and environmental exposure.

Abstract:

:The median latency of 2 degrees MDS/AL is 4 to 5 years. A high percentage of patients with 2 degrees MDS/AL convert to 2 degrees AL. Survival of either is less than 1 year. A constellation of morphologic abnormalities from all 3 cell lines produces a unique appearance. Both 2 degrees MDS and 2 degrees AL are difficult to classify by the FAB system. With the exception of the identification of karyotypic abnormalities, the biology of 2 degrees MDS/AL remains largely unexplored. Alterations of chromosomes 5 and 7 predominate, but other associated cytogenetic abnormalities are being increasingly recognized. A synthesis of data regarding 2 degrees MDS/AL resulting from the treatment of several primary malignancies generates the tentative conclusions that (a) many of the alkylating agents, and the nonclassic alkylating agent procarbazine, are leukemogens; (b) melphalan is a more potent leukemogen than cyclophosphamide. None of the other alkylating agents has been clearly established to be more or less potent than another; (c) increasing duration or amount of alkylator-based chemotherapy increases the risk of leukemogenesis; (d) low doses of radiation delivered to large volumes of bone marrow are weakly leukemogenic. High doses of radiation delivered to small volumes are not. Due to the latter, there is minimal additive risk for 2 degrees MDS/AL among studies using alkylator-based chemotherapy and radiotherapy, either concurrently or sequentially; (e) the older patient (greater than 40) is at increased risk for 2 degrees MDS/AL, at least in Hodgkin's disease. Children may be at lesser risk than adults, and younger children at lesser risk than older children; (f) the risk of 2 degrees MDS/AL peaks within the first decade after treatment for the primary malignancy. The incidence rates during the second decade are low. Identified occupational/environmental risks for 2 degrees MDS/AL include benzene, ambient and diagnostic radiation exposure, and perhaps ethylene oxide. The similarities in karyotype abnormalities among leukemic cells of those whose occupations expose them to chemical hazard, and those who are exposed to cytotoxic agents, suggest that many more environmental leukemogens have yet to be discovered. Karyotype is an important prognostic factor for both achievement of CR and for survival. Nonaggressive treatment approaches have not proven useful, although the use of hematopoietic growth factors offers promise in this area. Combination chemotherapy is justified in patients with adequate performance statuses and "favorable" karyotypes. Allogeneic bone marrow transplantation is currently the only curative approach, and can be applied without attempts to first reduce the leukemic burden.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Levine EG,Bloomfield CD

subject

Has Abstract

pub_date

1992-02-01 00:00:00

pages

47-84

issue

1

eissn

0093-7754

issn

1532-8708

journal_volume

19

pub_type

杂志文章,评审
  • Challenges in the management of stage II colon cancer.

    abstract::Approximately one third of patients diagnosed with early-stage colon cancer will present with lymph node involvement (stage III) and about one quarter with transmural bowel wall invasion but negative lymph nodes (stage II). Adjuvant chemotherapy targets micrometastatic disease to improve disease-free (DFS) and overall...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2011.05.005

    authors: Dotan E,Cohen SJ

    更新日期:2011-08-01 00:00:00

  • Is there a place for "dose-dense" weekly schedules of the taxoids?

    abstract::The recommended weekly dose and the maximum tolerated weekly dose of docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) have yet to be determined. We report that a weekly dose of up to 40 mg/m2 docetaxel for 6 weeks is active in pretreated patients with metastatic breast cancer. From a preliminary study, this d...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:

    authors: Löffler TM

    更新日期:1998-10-01 00:00:00

  • The interface between medical oncology and supportive and palliative cancer care.

    abstract::Traditionally, medical oncology has focused on the active period of diagnosis, treatment and follow-up of cancer patients, and palliative medicine, the pre-terminal and end-of-life phases. Palliative medicine physicians have particular expertise in communication and symptom control, especially, for example, with pain ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/j.seminoncol.2011.03.021

    authors: Storey DJ,Fallon MT,Smyth JF

    更新日期:2011-06-01 00:00:00

  • Farnesyltransferase inhibitors.

    abstract::The targeting of molecular abnormalities in neoplasms may provide an opportunity to improve the selectivity of cancer therapy. Ras mutations are a common genetic event in human cancers. Other genetic changes in tumors can signal through ras-dependent pathways as well. The targeting of ras through the inhibition of Ras...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1016/s0093-7754(01)90286-6

    authors: Hahn SM,Bernhard E,McKenna WG

    更新日期:2001-10-01 00:00:00

  • Clinical trials with ifosfamide: the Indiana University experience.

    abstract::At Indiana University, we began clinical trials with ifosfamide in 1981. Although our initial efforts were in a variety of tumor types, including pancreatic cancer, we have most recently focused our attention on two tumors that have historically exhibited a higher degree of chemosensitivity--testicular cancer and smal...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Loehrer PJ,Williams SD,Nichols CR,Einhorn LH

    更新日期:1992-02-01 00:00:00

  • Defining the clinical diagnosis of inflammatory breast cancer.

    abstract::Inflammatory breast cancer (IBC) is an extremely aggressive disease that progresses rapidly and carries a very grim prognosis. It is characterized by erythema, rapid enlargement of the breast, skin ridging, and a characteristic peau d'orange appearance of the skin secondary to dermal lymphatic tumor involvement. Altho...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2007.11.010

    authors: Singletary SE,Cristofanilli M

    更新日期:2008-02-01 00:00:00

  • Single-agent gemcitabine in non-small cell lung cancer: the French experience.

    abstract::Gemcitabine is a novel nucleoside analogue that has demonstrated activity against several solid tumors. A large phase II study has been performed in Europe and Canada with a total enrollment of 161 non-small cell lung cancer patients, 26 of whom were from the Institut Gustave-Roussy. Patient characteristics were the s...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:

    authors: Le Chevalier T,Gottfried M

    更新日期:1997-04-01 00:00:00

  • The use of ondansetron in patients receiving multiple-day cisplatin regimens.

    abstract::The control of nausea and vomiting in patients receiving multiple-day cisplatin chemotherapy has remained difficult, even with the use of combination antiemetic regimens containing metoclopramide. Although these patients receive a lower daily dose of cisplatin, the emetogenic potential remains high. In addition, many ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Hainsworth JD

    更新日期:1992-08-01 00:00:00

  • From monoclonal antibodies to chimeric antigen receptors for the treatment of human malignancies.

    abstract::Monoclonal antibodies (mAbs) and their directly derived cell-based application known as chimeric antigen receptors (CARs) ensue from the need to develop novel therapeutic strategies that retain high anti-tumor activity, but carry reduced toxicity compared to conventional chemo- and radiotherapies. In this concise revi...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2014.08.005

    authors: Caruana I,Diaconu I,Dotti G

    更新日期:2014-10-01 00:00:00

  • Colon cancer in older adults.

    abstract::Colorectal cancer (CRC) is a common malignancy in the elderly. Randomized trials have demonstrated that adjuvant and palliative chemotherapy for CRC improves survival and quality of life. Unfortunately, there is a lack of evidence-based data about elderly patients to guide decisions regarding therapy. Clinical trials ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2008.08.004

    authors: Raftery L,Sanoff HK,Goldberg R

    更新日期:2008-12-01 00:00:00

  • The new staging system for cutaneous melanoma in the era of lymphatic mapping.

    abstract::In 2002, the American Joint Committee on Cancer (AJCC) revised the staging system for cutaneous melanoma on the basis of a survival analysis of important melanoma prognostic factors. Features of the revised system include new strata for primary tumor thickness, incorporation of primary tumor ulceration as an important...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2004.03.018

    authors: Rousseau DL Jr,Gershenwald JE

    更新日期:2004-06-01 00:00:00

  • Characterization of outcomes in patients with metastatic non-small cell lung cancer treated with programmed cell death protein 1 inhibitors past RECIST version 1.1-defined disease progression in clinical trials.

    abstract::Based on anecdotal cases of clinically important decreases in tumor size following initial evidence of disease progression when treating patients with anti-PD-1 therapies, investigators have conducted clinical trials in patients with metastatic non-small lung cancer (mNSCLC) receiving anti-PD-1 therapy allowing for tr...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,多中心研究,评审

    doi:10.1053/j.seminoncol.2017.01.001

    authors: Kazandjian D,Keegan P,Suzman DL,Pazdur R,Blumenthal GM

    更新日期:2017-02-01 00:00:00

  • Familial cancer and cancer families.

    abstract::From this brief review is should be evident that the hereditary varieties of common cancers are characterized by a high degree of genetic heterogeneity. The specific types of hereditary cancers can be identified by focusing on the histologic types and sites of involvement, not only of the primary neoplasm, but also of...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Anderson DE

    更新日期:1978-03-01 00:00:00

  • Small cell carcinoma of the head and neck: a review.

    abstract::Small cell carcinoma (SCC) has become recognized as a distinct, though relatively infrequent, clinical pathology that occurs in multiple sites throughout the head and neck. Excluding cases that are considered to arise from skin, SCC in the head and neck has been found to develop in nearly all structures associated wit...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2006.10.024

    authors: Renner G

    更新日期:2007-02-01 00:00:00

  • Combined cytotoxic and endocrine treatment of postmenopausal patients with advanced breast cancer: preliminary results of a phase II study of the combination of prednimustine, novantrone, methotrexate, 5-fluorouracil, and tamoxifen.

    abstract::Postmenopausal patients with advanced measurable and/or evaluable breast cancer entered a phase II trial of multiple agent cytotoxic therapy combined with endocrine therapy. Cycles of PNMF (prednimustine, novantrone, methotrexate, and 5-fluorouracil) were repeated every 4 weeks as follows: P, 100 mg/m2 PO on days 1 to...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:

    authors: Mouridsen HT,Andersson M,Pedersen L

    更新日期:1986-03-01 00:00:00

  • Diagnosis and prevention of gastrointestinal malignancies.

    abstract::The consistently high mortality rates associated with gastrointestinal cancer result in large part from malignancies that progress undetected to an advanced stage of disease when treatment is usually less effective. In response to this fact, increasing attention has been directed toward developing methods of both prim...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Winawer SJ

    更新日期:1991-02-01 00:00:00

  • Acute promyelocytic leukemia: recent advances in diagnosis and management.

    abstract::Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) characterized by a specific genetic alteration, affecting the retinoic acid receptor-alpha (RARalpha), and leading to a blockage in the differentiation of the granulocytic cells. The accumulation of the promyelocytic blasts in the...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/j.seminoncol.2008.04.010

    authors: Lo-Coco F,Ammatuna E,Montesinos P,Sanz MA

    更新日期:2008-08-01 00:00:00

  • Spirituality and healing.

    abstract::Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it a...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/j.seminoncol.2004.11.017

    authors: Torosian MH,Biddle VR

    更新日期:2005-04-01 00:00:00

  • Front-line therapy for advanced colorectal cancer: emphasis on chemotherapy.

    abstract::For four decades, 5-fluorouracil was the only option available for patients with metastatic colorectal cancer. It provided a response rate of 15% to 20%, with a median survival of approximately 1 year. In the past 5 years, remarkable progress has been made in colorectal cancer research with the approval of irinotecan ...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2005.04.022

    authors: Varadhachary GR,Hoff PM

    更新日期:2005-12-01 00:00:00

  • Monoclonal antibody treatment of solid tumors: a coming of age.

    abstract::Over the past 5 years there has been a renewed interest in the use of monoclonal antibodies and immunoconjugates in the treatment of nonhematologic malignancies. This enthusiasm has stemmed from advances in recombinant technology allowing for the production of chimeric and humanized antibodies, from Food and Drug Admi...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Murray JL

    更新日期:2000-12-01 00:00:00

  • Salvage chemotherapy in recurrent or refractory squamous cell cancer of the uterine cervix.

    abstract::Squamous cell cancer of the cervix is a relatively drug-resistant tumor. Therefore, chemotherapy is predominantly reserved for cervical cancer patients with recurrent or refractory disease following surgery and/or radiation therapy or for patients who present with far advanced, incurable disease. Objective responses t...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Alberts DS,Garcia DJ

    更新日期:1994-08-01 00:00:00

  • Radiation therapy in pregnancy: risk calculation and risk minimization.

    abstract::The benefits of radiation therapy (RT) as part of a treatment regimen for cancer must be weighed against the potential risk of harm to the patient and in the pregnant patient, the risk to the developing fetus. Information necessary for determining the potential effects of RT on the developing fetus include the gestati...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Greskovich JF Jr,Macklis RM

    更新日期:2000-12-01 00:00:00

  • Epidemiology of bone and soft tissue sarcomas.

    abstract::Although bone and soft tissue sarcomas are not common, a significant number of patients who develop these tumors will die with metastatic disease. Part of the reason is that many of the patients have advanced disease at diagnosis. Identification of an etiologic agent should allow for diagnosis at an earlier stage. Thi...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: McClay EF

    更新日期:1989-08-01 00:00:00

  • Modeling toxicity and response in carboplatin-based combination chemotherapy.

    abstract::Data from women with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III or IV) were analyzed to evaluate the pharmacokinetic/pharmacodynamic relationships of carboplatin-based combination chemotherapy. With the equation area under the plasma concentration versus time curve (AUC) =...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Egorin MJ,Reyno LM,Canetta RM,Jodrell DI,Swenerton KD,Pater JL,Burroughs JN,Novak MJ,Sridhara R

    更新日期:1994-10-01 00:00:00

  • Recent updates on the role of chemotherapy in pancreatic cancer.

    abstract::Single-agent gemcitabine remains the standard treatment for advanced pancreatic cancer. Recent phase III trials have failed to show improvements in survival using gemcitabine in combination with other chemotherapeutic agents, although the gemcitabine/oxaliplatin combination has shown some promise. The combination of g...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2005.06.022

    authors: Burris HA 3rd

    更新日期:2005-08-01 00:00:00

  • CPT-11: clinical experience in phase I studies.

    abstract::Phase I studies of CPT-11 (irinotecan) have been conducted in Europe, the United States, and Japan to determine the maximum tolerated dose (MTD) and the most appropriate intravenous administration schedule for further evaluation in phase II investigations. Diarrhea and/or neutropenia were the major dose-limiting toxic...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Armand JP

    更新日期:1996-02-01 00:00:00

  • The development of busulfan/cyclophosphamide preparative regimens.

    abstract::Bone marrow transplantation (BMT) preparative regimens consisting of busulfan (Bu) and cyclophosphamide (Cy) were developed as an alternative to preparative regimens based on total body irradiation (TBI). Animal studies demonstrated that Bu had a high level of myeloablative and antileukemic activity, but little immuno...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:

    authors: Santos GW

    更新日期:1993-08-01 00:00:00

  • Rituximab in combination with CHOP or fludarabine in low-grade lymphoma.

    abstract::Non-Hodgkin's lymphoma (NHL) is composed of a group of lymphoid malignancies that has been increasing in incidence at an annual rate of 4% to 7% over the last 20 years in both the United States and Europe. The reasons for this rise in incidence in NHL are not yet defined but most likely involve environmental exposures...

    journal_title:Seminars in oncology

    pub_type: 杂志文章

    doi:10.1053/sonc.2002.30152

    authors: Czuczman MS,Fallon A,Mohr A,Stewart C,Bernstein ZP,McCarthy P,Skipper M,Brown K,Miller K,Wentling D,Klippenstein D,Loud P,Rock MK,Benyunes M,Grillo-López AJ,Bernstein SH

    更新日期:2002-02-01 00:00:00

  • A randomized study of gemcitabine monotherapy versus etoposide/cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer.

    abstract::This randomized, multinational, multicenter study was designed to determine the response rate of gemcitabine monotherapy and cisplatin/etoposide combination therapy in chemotherapy-naive patients with advanced, recurrent, and/or metastatic non-small cell lung cancer (stage IIIA [if inoperable], IIIB, or IV). One group...

    journal_title:Seminars in oncology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Manegold C,Drings P,von Pawel J,Ricci S,Dornoff W,van Walree N,ten Bokkel Huinink W,Chemaissani A,Stahel P,Bergman B,Wagenius G,Sederholm C,Mattson K,Liippo K,Kellokumpu-Lehtinen P

    更新日期:1997-06-01 00:00:00

  • Myeloma: classification and risk assessment.

    abstract::Multiple myeloma (MM) is a heterogeneous disease for which several new treatments are available. Much has been learned about its biology over the past 15 years. We now understand that there are various subtypes of the disease, each one associated with different outcomes and clinical pathological features. While a deta...

    journal_title:Seminars in oncology

    pub_type: 杂志文章,评审

    doi:10.1053/j.seminoncol.2013.07.002

    authors: Fonseca R,Monge J

    更新日期:2013-10-01 00:00:00