SECONDARY ACUTE-LEUKEMIA AND MYELODYSPLASTIC SYNDROME WITH 11Q23 ABNORMALITIES

Forty of the 550 patients (7%) entered to the 11q23 Workshop had secon dary (s) acute lymphoblastic leukemia (nine cases), s-acute myeloid le ukemia (25 cases, predominantly of FAB type M5), s-acute leukemia unsp ecified (one case) or s-myelodysplastic syndrome (five cases) followin g treatment for a primary malignancy. Breast cancer (12 cases) and non -Hodgkin's lymphoma (eight cases) were the most frequent primaries. Tw enty-three patients had been treated with either an epipodophyllotoxin (seven patients) or an anthracycline (10 cases) or both (four cases) frequently combined with alkylating agents (12 cases) and with radioth erapy (six cases). Two further patients had alkylating agents and two had radiotherapy alone. Time between diagnosis of the primary and seco ndary malignancy was between 10 months and 22 years (median 24 months) . The incidence of secondary malignancies in 11q23 subgroups was: t(11 ;19)(q23;p13.1) (33%), t(9;11) (8%), t(4;11) (5.5%), t(10;11)(5%), t ( 6;11) (3%), del11q23(2%) and 10 patients had a rare 'other' abnormalit y. No associations were seen between type of prior malignancy and 11q2 3 subgroup, or between prior malignancy and leukemia subtype. Remissio n, when achieved (32 patients), was short (median 5 months). Two patie nts survived following a bone marrow transplant for s-leukemia and s-m yelodysplastic syndrome.