Stem cell transplantation is an effective treatment option for breast cancer survivors who develop acute leukemia or myelodysplasia following adjuvant chemotherapy, according to the results of a study published in the Annals of Oncology.
Breast cancer patients who receive adjuvant chemotherapy and/or radiation treatment have a small (1%) risk of developing myelodysplasia, which usually progresses to acute myeloid leukemia (AML). Stem cell transplantation (SCT) involves high doses of chemotherapy followed by infusion of stem cells (allogeneic SCT uses donor cells; autologous SCT uses the patient’s own cells). Long-term survival for AML is low; however allogeneic SCT has been associated with a 20% cure rate.
A study conducted at the City of Hope National Medical Center involved 14 women with secondary AML and one with myelodysplasia. Ten of these patients had developed their secondary cancer within two years of treatment for breast cancer. Twelve patients underwent stem cell transplantation (11 allogeneic, one autologous). After a median follow-up of 20 months, 11 of the 12 patients who underwent transplantation were in remission.
The researchers concluded that patients who develop secondary AML/myelodysplasia following adjuvant treatment for breast cancer can achieve durable remission after undergoing allogeneic stem cell transplantation. They suggest that stem cell transplantation “should be an early consideration in the management of such patients who are suitable candidates for the procedure.”
 Pullarkat V, Slovak ML, Dagis A, et al. Acute leukemia and myelodysplasia after adjuvant chemotherapy for breast cancer: Durable remissions after hematopoietic stem cell transplantation. Annals of Oncology[early online publication]. June 29, 2009. DOI: 10.1093/annonc/mdp232.
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