MDS following prior cancer chemo

[donna j.]

Does anyone know what specific information from our testing, BMB, etc indicates the onset of MDS from being treated previously with chemo for a prior cancer? Robin Roberts assertion that she got this from her breast cancer chemo, makes me wonder if this is an educated leap by her doctors, or is there a marker or profile which tells the doctor that MDS has definitely come from the chemo?

thanks,

Donna

[DanL]

Donna,

This is a very good question.

Per the NIH:
Cases are attributed to prior therapy based on circumstantial evidence, such as the following: 1) presence of typical clonal cytogenetic abnormalities, 2) significant exposure to leukemogenic therapy (e.g., at least one cycle), and 3) sufficient latency from exposure to diagnosis of t-MDS (e.g., at least six months).

A high rate of MDS is found in patients who have had prior treatement that includes total body irradiation, alkalyting agents, or topoisomerase inhibitors.

Loss of material from chromosomes 5 and/or 7 is detectable in up to 70% of t-MDS/AML patients, often with other abnormalities in a complex karyotype. The same pattern of cytogenetic abnormalities occur in de novo MDS, but at much lower frequency.

The article that I picked this information up from is fairly complex, but does a good job of explaining what the rationale for believient that MDS is therapy related or not.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832708/

I hope this helps.
Dan