6533b7d6fe1ef96bd1267006

RESEARCH PRODUCT

Acute myeloid leukemia in Italian patients with multiple sclerosis treated with mitoxantrone

V. MartinelliE. CoccoR. CapraG. SalemiP. GalloM. CapobiancoI. PesciA. GhezziCarlo PozzilliA. LugaresiP. BellantonioM. P. AmatoL. M. GrimaldiM. TrojanoG. L. MancardiR. BergamaschiClaudio GasperiniM. RodegherL. StraffiM. PonzioG. Comi For The Italian Mitoxantrone GroupM RadaelliF EspositoL MoiolaB ColomboP RossiMg MarrosuJ FrauL LoreficeG CogheGiovanni SavettieriP RagoneseV CusimanoP PeriniF RinaldiA VidaliA BertolottoS MalucchiA Di SapioE MontanariA GuareschiA RizzoM ZaffaroniS BaldiniN De RossiC CordioliS RasiaM SalvettiC ButtinelliLuca Ausili CefaroG De LucaD TommasoD FarinaR FantozziS RuggieriMp AmatoB HakikiV ZipoliE PortaccioMl BartolozziC ScandellariS StecchiLp MarchelloB PalmeriG VitelloP IaffaldanoG LuccheseV DattolaM BuccafuscaP SolaAm SimoneF BarrecaF PattiP LaisaP CavallaS MaseraE TavazziS GalganiG TedeschiR SaccoL ProvincialiD MauraG LusG AlfieriA TiccaMl PirasD MaimoneM BiancaA IudiceMe GiroM GaleottiC FlorioP SpitalieriL La MantiaL MottiMr RottoliF GranellaC SolaroE ScarpiniG ServilloG. Cavaletti

subject

Malemedicine.medical_specialtyMyeloidmitoxantrone; acute myelocytic leukemia; multiple sclerosisPopulationmultiple sclerosisStatistics NonparametricmitoxantroneFollow-Up StudieArts and Humanities (miscellaneous)Retrospective StudieInternal medicineMultiple SclerosimedicineHumansmultiple sclerosis leukemia mitoxantroneProspective cohort studyeducationRetrospective StudiesAgedAnalgesicseducation.field_of_studyMitoxantroneCumulative dosebusiness.industryMultiple sclerosisIncidence (epidemiology)leukemiaMyeloid leukemiaRetrospective cohort studymedicine.diseaseConfidence intervalSurgeryLeukemiaLeukemia Myeloid Acutemedicine.anatomical_structureItalyCohortSettore MED/26 - NeurologiaAnalgesicFemaleNeurology (clinical)acute myelocytic leukemiaMitoxantronebusinessFollow-Up Studiesmedicine.drugHuman

description

none 25 no Abstract OBJECTIVES: To evaluate the incidence and dose-dependency of mitoxantrone (MTX)-associated acute myelocytic leukemia (AML) in the network of Italian multiple sclerosis (MS) clinics. METHODS: We performed a multicenter retrospective cohort study of patients treated with MTX in MS centers under the Italian national health care system between 1998 and 2008. Demographic, disease, treatment, and follow-up information were collected using hospital records. RESULTS: Data were available for 3,220 patients (63% women) from 40 Italian centers. Follow-up (mean ± SD) was 49 ± 29 months (range 12-140 months). We observed 30 cases of AML (incidence 0.93% [95% confidence interval 0.60%-1.26%]). The mean cumulative dose was higher in patients with AML (78 vs 65 mg/m(2), p = 0.028). The median interval from the start of therapy to AML diagnosis was longer than expected at 33 months (range 13-84 months); 8 patients (27%) developed AML 4 years or more after the first MTX infusion. The rate of mortality associated with AML was 37%. CONCLUSIONS: This higher than expected risk of AML and related mortality requires that treatment decisions must be made jointly between clinicians and patients who understand their prognosis, treatment options, and treatment-related risks. The now large exposed MS population must be monitored for hematologic abnormalities for at least 6 years from the end of therapy, to ensure the rapid actions needed for early diagnosis and treatment of AML. none Martinelli V; Cocco E; Capra R; Salemi G; Gallo P; Capobianco M; Pesci I; Ghezzi A; Pozzilli C; Lugaresi A; Bellantonio P; Amato MP; Grimaldi LM; Trojano M; Mancardi GL; Bergamaschi R; Gasperini C; Rodegher M; Straffi L; Ponzio M; Comi G; For The Italian Mitoxantrone Group; De Luca G; Di Tommaso V; Farina D Martinelli V; Cocco E; Capra R; Salemi G; Gallo P; Capobianco M; Pesci I; Ghezzi A; Pozzilli C; Lugaresi A; Bellantonio P; Amato MP; Grimaldi LM; Trojano M; Mancardi GL; Bergamaschi R; Gasperini C; Rodegher M; Straffi L; Ponzio M; Comi G; For The Italian Mitoxantrone Group; De Luca G; Di Tommaso V; Farina D

yearjournalcountryeditionlanguage
2011-01-01
10.1212/wnl.0b013e318238ee00http://hdl.handle.net/11573/477761