Acute Myeloblastic Leukemia as a Second Malignancy in a Patient With Hereditary Retinoblastoma

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2001.19.21.4182 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11689590 Acute Myeloblastic Leukemia as a Second Malignancy in a Patient With Hereditary Retinoblastoma Shin-ichiro NishimuraxShin-ichiro NishimuraSearch for articles by this author , Takashi SatoxTakashi SatoSearch for articles by this author , Haruo UedaxHaruo UedaSearch for articles by this author , Kazuhiro UedaxKazuhiro UedaSearch for articles by this author Maja Nenadov BeckxMaja Nenadov BeckSearch for articles by this author Show More Hiroshima University School of Medicine, Hiroshima, JapanUniversity Hospital, Lausanne, Switzerland https://doi.org/10.1200/JCO.2001.19.21.4182 First Page Full Text PDF Figures and Tables © 2001 by American Society of Clinical OncologyjcoJ Clin OncolJournal of Clinical OncologyJCO0732-183X1527-7755American Society of Clinical OncologyResponse01112001In Reply:The possibility that first-line chemotherapy in retinoblastoma (Rbl) could induce secondary acute myeloblastic leukemia due to prolonged use of topoisomerase II inhibitors is a real concern, as illustrated by Nishimura et al. Our article,1 however, did not emphasize the safety of the applied chemotherapeutic strategy but considered the risk as low with regard to the moderate cumulative doses of etoposide used.2 As the authors point out, some patients can be cured with local treatment alone or enucleation, and in fact, they were not part of the patient group included in our study.There is some evidence that other agents, such as platinum compounds, especially carboplatin, can contribute to the development of secondary leukemia. A relative risk of 7.6 for a cumulative dose ≥ 1,000 mg has been observed in women treated for ovarian cancer.3 The risk seems to be increased when radiotherapy is added to platinum-based chemotherapy. As most chemotherapeutic regimens used for Rbl patients comprise both agents and sometimes additional external-beam irradiation is needed, special consideration must be given to follow-up and new treatment strategies.Nishimura et al’s case report shows that secondary acute myeloblastic leukemia can occur after chemotherapy in hereditary Rbl, but its precise risk still needs to be determined. 1. Beck MN, Balmer A, Dessing C, et al: First-line chemotherapy with local treatment can prevent external-beam irradiation and enucleation in low-stage intraocular retinoblastoma. J Clin Oncol 18:: 2881,2000-2887, Link, Google Scholar2. Smith MA, Rubinstein L, Anderson JR, et al: Secondary leukemia or myelodysplastic syndrome after treatment with epipodophyllotoxins. J Clin Oncol 17:: 569,1999-577, Link, Google Scholar3. Travis LB, Holowaty EJ, Bergfeldt K, et al: Risk of leukaemia after platinum-based chemotherapy for ovarian cancer. N Engl J Med 340:: 351,1999-357, Crossref, Medline, Google Scholar