Development of acute myeloid leukemia after chemotherapy for osteosarcoma

The current study describes two patients with osteosarcoma who had acute my eloid leukemia develop after treatment with multiagent chemotherapy. The in cidence density for the chemotherapy protocol was 129.8 per 10,000 person-y ear of followup. Karyotype analysis of 16 reported patients (including the current two patients) indicated that most leukemias after treatment of oste osarcoma correlated with the use of topoisomerase H inhibitors, such as dox orubicin. The deoxyribonucleic acid-damaging activity of doxorubicin reinfo rced by the use of alkylating agents is highly suspected as a causative eve nt in the development of leukemia after treatment of osteosarcoma. As the n ext step in the development of treatment for patients with osteosarcoma, th e type and intensity of treatment must be evaluated to minimize possible le ukemogenic effects without compromising the potential for cure.