Chronic Myeloid Leukemia Following Treatment for Primary Neoplasms or Other Medical Conditions

Lian-He Yang; Pu Su; Catherine Luedke; Chuanyi Mark Lu; Abner Louissaint; Chad M McCall; Sarah Rapisardo; Bethany Vallangeon; Endi Wang

doi:10.1093/ajcp/aqy050

Chronic Myeloid Leukemia Following Treatment for Primary Neoplasms or Other Medical Conditions

Am J Clin Pathol. 2018 Jul 31;150(3):246-258. doi: 10.1093/ajcp/aqy050.

Authors

Lian-He Yang^{1

2}, Pu Su^{2

3}, Catherine Luedke², Chuanyi Mark Lu⁴, Abner Louissaint⁵, Chad M McCall², Sarah Rapisardo², Bethany Vallangeon⁶, Endi Wang²

Affiliations

¹ Department of Pathology, First Affiliated Hospital and College of Basic Sciences of China Medical University, Shenyang, China.
² Department of Pathology, Duke University Medical Center, Durham, NC.
³ Department of Medicine, East Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
⁴ Department of Laboratory Medicine, University of California San Francisco.
⁵ Department of Pathology and Laboratory Medicine, Massachusetts General Hospital, Harvard Medical School, Boston.
⁶ Department of Pathology, East Carolina University Medical Center, Greenville, NC.

PMID: 29992292
DOI: 10.1093/ajcp/aqy050

Abstract

Objectives: Therapy-related chronic myeloid leukemia (CML) has been reported, but its clinical presentation and pathologic features have not yet been well characterized.

Methods: Twenty-one cases of CML following treatment for primary diseases were collected and retrospectively analyzed.

Results: The clinical presentation, pathologic features, and cytogenetic profile were similar to de novo CML. In particular, those with an isolated Philadelphia chromosome constituted 88.9% of our cases, and additional aberrations characteristic of therapy-related acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) were not identified in this study. The patients responded to imatinib/derivatives and survived with limited follow-up.

Conclusions: Therapy-related CML has a clinical presentation, pathologic features, and cytogenetic profile akin to de novo CML. Absence of additional significant aberrations seems to suggest a pathogenesis different from therapy-related AML/MDS. Therapy-related CML exhibits a robust therapeutic response to imatinib/derivatives and favorable clinical outcomes similar to de novo CML.

Keywords: Chronic myeloid leukemia; Cytogenetic profile; Philadelphia chromosome; Therapy-related.