Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

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Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

Ditte Juel Adolfsen Løhmann, Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark
Authors: Ditte Juel Adolfsen Løhmann and Henrik Hasle.

Therapy-related myelodysplastic syndrome/acute myeloid leukaemia (t-MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two years after finishing treatment.
We included all children (n=14) who where diagnosed from October 2006 to January 2011 at our department and treated according to the EURAMOS-1 protocol. Four patients relapsed and died before the end of the study period.
We found noteworthy changes in MCV, platelets and ANC. MCV increased from median 83 fL at diagnosis to a maximum of 98 six months after the last chemotherapy course and then stabilized around 93 fL for the rest of the study period. Platelets decreased from a median of 309 x109/L at diagnosis to 173 at six months, and stabilized at around 200 x109/L, and ANC decreased from a median of 4.64 x 109/L at diagnosis to a minimum of 2.18 at 18 months and increased slightly to 2.93 at 24 months. Haemoglobin normalized after one month and remained within the normal range.
Within the study period two cases had a bone marrow examination performed. In one case MDS (refractory anaemia with excess blasts) with monosomy 7 was found and a hematopoietic stem cell transplant was performed. In the other case MDS without excess of blasts was found and a spontaneous normalization of the biochemistry occurred.
In conclusion in our study most patients treated for osteosarcoma developed haematological abnormalities similar to early MDS but few developed t-MDS/AML. Close monitoring of patients recovering from osteosarcoma is essential.

Keywords: Osteosarcoma, t-MDS/AML, Haematological abnormalities, Children
Original languageEnglish
Publication yearJun 2013
Number of pages1
Publication statusPublished - Jun 2013
EventNOPHO 31st Annual Meeting Copenhagen - København, Denmark
Duration: 31 May 20134 Jun 2013

Conference

ConferenceNOPHO 31st Annual Meeting Copenhagen
CountryDenmark
CityKøbenhavn
Period31/05/201304/06/2013

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