Acute myeloid leukemias and myelodysplastic syndromes associated with previous cytotoxic therapy. Characteristic features, prognosis, and treatment approaches

Introduction. Over the past decades, a number of classifications and their updates have been developed for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Myeloid neoplasms (MN) after previous therapy for other diseases had different designations. The fifth edition of the WHO classification provides the most accurate definition of these neoplasmes — MN post cytotoxic therapy (MN-pCT). The problem of choosing therapy for these MN is largely related to previous treatment of the first oncological disease.

Aim: to present the difficulties of classifying MN induced by previous cytotoxic chemotherapy of a hematologic malignancy and a solid tumor, as well as the difficulties of determining the prognosis and choosing a treatment method.

Main findings. Clinical cases of MDS after chemotherapy of AML and AML after anticancer treatment of osteosarcoma are described. The anamnesis, diagnostics procedures are reported in detail, and the choice of therapy is justified. Risk stratification of patients with MN associated with previous cytotoxic therapy is discussed.

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