Therapy-related myelodysplastic syndrome and myeloid leukemia

Therapy-related myeloid leukemia (t-MDS/t-AML) is a well-recognized clinical syndrome occurring as a late complication following cytotoxic therapy (1-4). The term “therapy-related” leukemia is based on a patient’s history of exposure to cytotoxic agents. Although a causal relationship is implied, the mechanism remains to be proven. These neoplasms are thought to be the direct consequence of mutational events induced by the prior therapy. Table 1 shows the various primary diagnoses and primary cytotoxic therapies received by 306 patients with therapy-related myeloid leukemia studied at the University of Chicago (3).