Acute leukemia and cytogenetic abnormalities complicating melphalan treatment of primary systemic amyloidosis

Morie Gertz, R. A. Kyle

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

We followed up 153 patients with biopsy-proven primary systemic amyloidosis to determine their risk for acute nonlymphocytic leukemia or a dysmyelopoietic syndrome. In 10 patients cytogenetic abnormalities developed consistent with alkylator-induced damage to hematopoietic cells. In this group, the total melphalan dose ranged from 476 to 2450 mg (median, 1764 mg) administered over 21 to 92 months (median, 38 months). Eight of the 10 patients died as a direct result of pancytopenia, 1 died of progressive renal amyloid, and 1 remains alive with persistent complex cytogenetic abnormalities. Four patients had acute nonlymphocytic leukemia; 5 had a dysmyelopoietic syndrome; and 1 had a nondiagnostic bone marrow examination. Although only 6.5% of the entire group had leukemia or a dysmyelopoietic syndrome, the actuarial risk in patients surviving 3.5 years was 21%. Median survival from onset of dysmyelopoietic syndrome or acute leukemia was 8.1 months.

Original languageEnglish (US)
Pages (from-to)629-633
Number of pages5
JournalArchives of Internal Medicine
Volume150
Issue number3
DOIs
StatePublished - Apr 5 1990

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Melphalan
Chromosome Aberrations
Myelodysplastic Syndromes
Leukemia
Acute Myeloid Leukemia
Bone Marrow Examination
Therapeutics
Pancytopenia
Alkylating Agents
Amyloid
Primary amyloidosis
Kidney
Biopsy
Survival

ASJC Scopus subject areas

  • Internal Medicine

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Acute leukemia and cytogenetic abnormalities complicating melphalan treatment of primary systemic amyloidosis. / Gertz, Morie; Kyle, R. A.

In: Archives of Internal Medicine, Vol. 150, No. 3, 05.04.1990, p. 629-633.

Research output: Contribution to journalArticle

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