Síndrome mielodisplásica secundária à quimio ou radioterapia: SMD relacionada a tratamento

• Autor(a) principal: Pinheiro, Ronald F. [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Chauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S1516-84842006000300010; http://repositorio.unifesp.br/handle/11600/3248
• topic: Secondary myelodysplastic syndrome; therapy related-MDS; chemotherapy-MDS; MDS-t; Síndrome mielodisplásica secundária; SMD relacionada a quimioterapia; SMD-t

The leukaemogenic effect of chemotherapeutic agents after treatment for other malignancies have been well described. Myelodysplastic syndrome secondary to chemo- and radiotherapy (MDS-t) usually develops four to seven years after the initial exposure to chemotherapy frequently involving young patients, shows a high incidence of transformation to AML, is associated with severe cytopenias, trilineage dysplasia, reduced marrow cellularity and fibrosis, and presents an incidence of chromosomal abnormalities of up to 80% of the cases. The most common abnormalities are related to chromosomes 5 and 7. Alkylating agents have been considered the most common drugs associated with MDS-t. High dose chemotherapy used as part of the conditioning regimen prior to bone marrow transplantation as well as traditional regimens such as COPP/ABV and BEACOPP have also been associated with MDS-t. Recently, drugs such as azathioprine, rituximab and cladribine have been reported as causes too. Due to the increasing survival of patients suffering from other malignancies, MDS-t results as a mutagenic effect of these therapies and is related to poor prognosis.