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Acute myeloid leukemia (AML) having evolved from essential thrombocythemia (ET): distinctive chromosome abnormalities in patients treated with pipobroman or hydroxyurea

Leukemia volume 16, pages 2078–2083 (2002)Cite this article

Abstract

ET is a chronic myeloproliferative disorder rarely evolving into AML, sometimes preceded by a myelodysplastic syndrome (MDS). Such transformations mostly occur in patients treated with radiophosphorous (32P) or alkylating agents, especially busulfan. Recently, concern has also arisen about the long-term safety of hydroxyurea (HU). Pipobroman (PI), a well tolerated and simple to use drug, constitutes a valid alternative to those cytoreductive treatments. The present study reports on 155 ET patients treated at our institution from 1985 to 1995, and monitored until December 2000. A good control of thrombocytosis was achieved with PI as the only treatment in 106 patients and with HU in 23 patients. Twenty-six patients received no treatment. After a median follow-up of 104 months, seven patients (four treated with HU, and three with PI) developed AML whereas one patient treated with PI developed MDS. A significant difference in progression-free survival was observed between HU- and PI-treated patients (P = 0.004). A short-arm deletion of chromosome 17 was most frequently detected in HU-treated patients, while a long-arm trisomy of chromosome 1 and a monosomy 7q were seen in PI-treated patients. No TP53 mutation was discovered in the six patients studied (two HU-treated and four PI-treated). We conclude that these cytogenetic abnormalities are not linked to the natural history of the disease, but rather that they might be induced by the cytoreductive treatment.

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Authors and Affiliations

  1. Department of Blood, Heart and Lung Medical Sciences of the University of Pavia and Division of Hematology, Policlinico San Matteo IRCCS, Pavia, Italy

    P Bernasconi, M Boni, PM Cavigliano, S Calatroni, E Brusamolino, F Passamonti, I Giardini, B Rocca, M Caresana, M Lazzarino & C Bernasconi

  2. Department of Clinical and Biological Sciences of the University of Turin, Azienda Ospedaliera San Luigi di Orbassano, Torino, Italy

    G Volpe

  3. Scientific Direction, Clinical Epidemiology and Biometry Unit, Policlinico San Matteo IRCCS, Pavia, Italy

    A Pistorio

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  1. P Bernasconi
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  2. M Boni
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Bernasconi, P., Boni, M., Cavigliano, P. et al. Acute myeloid leukemia (AML) having evolved from essential thrombocythemia (ET): distinctive chromosome abnormalities in patients treated with pipobroman or hydroxyurea. Leukemia 16, 2078–2083 (2002). https://doi.org/10.1038/sj.leu.2402638

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