Factors affecting response to treatment for secondary MDS and AML | Aplastic Anemia and MDS International Foundation

Factors affecting response to treatment for secondary MDS and AML

Original Publication Date: 
Friday, June 29, 2012

Note: This abstract was presented at the 2012 ASCO annual meeting in June 2012. The full abstract may be reviewed on the ASCO Annual Meeting Web site. Use the abstract number to access the full report.

Abstract # 6603

Secondary or t-MDS

It is important to recognize that, while secondary MDS (t-MDS) represents approximately 10% of MDS cases, the chance of developing MDS if you are treated for another cancer is very low - less than 1/2 of 1% (0.5%) in most cases, though the risk increases in patients who receive multiple rounds of chemotherapy and radiation therapy, and also in those who undergo stem cell transplants for conditions like lymphoma. Read more about t-MDS

Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are diseases of the blood and bone marrow that impact a significant number of patients with a need for better therapy.  Patients who have already been diagnosed with cancer in the past are considered to have secondary AML or secondary MDS.  This group of patients generally does not respond as well to treatment as patients with no cancer history.  An unanswered question is what factors are related to this poor outcome in secondary AML/MDS.  This  study at the M.D. Anderson Cancer Center in Texas  looked back at the patients in their center who had a diagnosis of secondary AML or secondary MDS to try to identify features that were associated with treatment  response.     

A total of 1073 patients with AML and 1109 patients with MDS were identified at the MD Anderson Cancer Center.  The number of prior cancers, the type of prior cancer, and the past treatments were all significantly related to patient survival.  Of the 2182 patients, 1907 had one prior cancer, 239 had 2 prior cancers, and 36 had 3 prior cancers.  Patients with more than 1 prior cancer had a significantly shorter time before they were diagnosed with secondary AML or MDS.  The most frequent types of prior cancers were blood cancer (25%), breast cancer (16%), prostate cancer (16%), and skin cancer (9%).  Patients who had kidney cancer in the past had a significantly shorter survival than patients with a history of lung cancer.  The treatment plans included surgery (1252 patients), radiation (939 patients), chemotherapy (1211 patients), or observation (124 patients).  Patients whose treatment plan included chemotherapy had a shorter survival time than patients who did not receive chemotherapy for their prior cancer(s).  For patients who had received chemotherapy, there was a significantly higher amount of genetic abnormalities present at the time of diagnosis of MDS or AML. 

Conclusions: 

Patients with AML and MDS that develop after a prior cancer diagnosis do poorly and this is particularly true for patients have received chemotherapy in the past.

There was a significant relationship between survival and the number of prior cancers a patient had where patients who had more prior cancers had worse outcomes.

Reviewer Bio: