Characteristics at the time of t-MN diagnosis and treatment outcomes.
| Case | Diagnosis | Age at t-MN diagnosis, years | Child-Pugh class | Latency perioda) | ECOG PS score | Bone marrow blast (%) | Splenomegaly | Cytogenetics risk group |
Treatment course | OS (mo) |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | t-AML | 52 | A | 52.3 | 2 | 75 | Yes | inv(16) | Died of multiorgan failure immediately after starting intensive chemotherapy | 0.5 |
| Favorable | ||||||||||
| 2 | t-AML | 45 | A | 36.4 | 1 | 21.5 | No | del(7) | Although the patient achieved CR after induction treatment, he died of sepsis after 2 cycles of consolidation treatment | 5.7 |
| Poor | ||||||||||
| 3 | t-AML | 65 | A | 16.8 | 1 | 84 | Yes | t(9;11) | Although the patient achieved CR after induction treatment, he died of sepsis after 1 cycle of consolidation treatment | 2.9 |
| Intermediate | ||||||||||
| 4 | t-APL | 65 | B | 22.1 | 2 | 93.4 | Yes | t(15;17) | Died of hepatic failure during induction treatment with idarubicin+tretinoin | 0.9 |
| Low | ||||||||||
| 5 | t-AML | 69 | A | 62.4 | 2 | 39 | Yes | Complex karyotypeb) | Died of sepsis after 3 cycles of decitabine treatment | 2.9 |
| Poor | ||||||||||
| 6 | t-MDS | 62 | A | 28.0 | 1 | 3.2 | No | del(20) | The patient achieved CR after 6 cycles of decitabine and received 3 more cycles of decitabine. The patient stopped treatment due to liver dysfunction and died of HCC progression. | 29.0 |
| Intermediate (IPSS-R 3.5) | ||||||||||
| 7 | t-MDS | 59 | B | 55.7 | 3 | 1.2 | No | Complex karyotypec) | Died of sepsis after 2 cycles of decitabine treatment | 2.8 |
| Very high (IPSS-R 10.0) | ||||||||||
| 8 | t-MDS | 72 | A | 64.1 | 1 | 1.2 | Yes | -Y | The only case to survive on erythropoietin | 11.5 |
| Low | ||||||||||
| (IPSS-R 2.0) |
a)From the date of the first TACE to the date of diagnosis of t-MN (mo). b)46,XY,inv(16)(p13.1q22)[3]/46,sl,del(2)(p13p23)[8]/46,sl,der(3)del(3) (p13p21)inv(3)(q12q23)[7]/46,XY[10]. c)45,XY,del(5)(q22q32),der(11)t(11;?;20)(q23;?;q11.2),-20,-21,+mar1[11]/45,idem,+der(11)del(p11.2) t(11;?;20),-18[11]/45,idem,t(2;21)(q11.2;q22),+21,-mar1[4]/46,idem,t(1;21)(p13;q22),+21,-mar1,+mar2[3]/46,XY[1].
Abbreviations: AML, acute myeloid leukemia; APL, acute promyelocytic leukemia; CR, complete remission; ECOG PS, Eastern Cooperative Oncology Group Performance Status; HCC, hepatocellular carcinoma; MDS, myelodysplastic syndrome; OS, overall survival; TACE, transcatheter arterial chemoembolization; t-MN, therapy-related myeloid neoplasm.