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According to an early online publication from the Journal of Clinical Oncology, the use of the chemotherapy agent Novantrone® (mitoxantrone) to treat breast cancer appears to increase the risk of developing acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) later in life.

Mitoxantrone is a chemotherapy agent that was historically used for the treatment of breast cancer. More recently, chemotherapy treatment combinations for breast cancer have tended to use classes of drugs referred to as anthracyclines and taxanes instead of mitoxantrone. However, mitoxantrone is still used for the treatment of some breast cancer patients.

Because patients diagnosed with breast cancer are living longer, researchers are now focusing on long-term side effects that may be caused by treatment.

Researchers from France recently conducted a clinical study in an attempt to determine potential risk factors for the development of AML or MDS following a diagnosis of breast cancer. AML and MDS are both cancers that arise from blood cells. The study included women treated in France for breast cancer between 1985 and 2001.

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  • Women treated with mitoxantrone-based therapy had nearly a threefold increased risk of developing subsequent AML or MDS, compared to those treated with anthracycline-based therapy.
  • Patients treated with radiation therapy also had an increased risk of developing AML or MDS.
  • Patients treated with granulocyte colony-stimulating factor (G-CSF) also appeared to have an increased risk of developing AML or MDS.

The researchers concluded that women treated for breast cancer with mitoxantrone-based chemotherapy appear to have an increased risk for developing subsequent AML or MDS. Patients may wish to speak with their physician regarding their individual risks and benefits of all treatment options.

Reference: Le Deley M-C, Suzan F, Cutuli B, et al. Anthracyclines, mitoxantrone, radiotherapy, and granulocyte colony-stimulating factor: risk factors for leukemia and myelodysplastic syndrome after breast cancer. Journal of Clinical Oncology [early online publication]. December 11, 2007. DOI: 10.1200/JCO.2006.05.9048.