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Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer

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Abstract

Background

Therapy-related acute myeloid leukemia (t-AML) associated with radioiodine treatment (RAI) is emerging as an important clinical entity with the rise in incidence of thyroid cancer.

Design and methods

We conducted an electronic search of MEDLINE and EMBASE, and also searched reference lists of articles and abstracts from conference proceedings for case reports and review articles on t-AML following radioiodine therapy. A total of 37 patients with acute myeloid neoplasms following radioiodine treatment were analyzed.

Results

The median RAI dose was 324 mCi, and median age was 47.5 years with M/F ratio of 1:3. Latency period was 1–4 years, and the median time from RAI exposure to diagnosis of t-AML was 2.9 years. FAB M2 and M3 were the two most common t-AML subtypes reported. Seventy-one percent of the cases that reported cytogenetic abnormalities were classified as unfavorable. The most commonly reported abnormalities were del 5q and t(15:17). Survival outcomes were not reported due to lack of patient-level data.

Conclusions

T-AML following radioiodine therapy for thyroid cancer appears to have a shorter latency period than other types of t-AML, which is an important consideration for post-therapy surveillance. Reporting of cases and outcomes will help provide data for further research. Identifying biomarkers that help risk-stratify patients prior to therapy and specific genetic-guided therapies may help improve outcomes.

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Authors and Affiliations

  1. Department of Medicine, Reading Health System, Sixth Avenue and Spruce Street, West Reading, PA, 19611, USA

    Adetokunbo Oluwasanjo, Ranjan Pathak & Anene Ukaigwe

  2. Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, 1365C Clifton Road NE, Suite 5010, Atlanta, GA, 30322, USA

    Olatunji Alese

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  1. Adetokunbo Oluwasanjo
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Correspondence to Adetokunbo Oluwasanjo.

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Oluwasanjo, A., Pathak, R., Ukaigwe, A. et al. Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer. Cancer Causes Control 27, 143–146 (2016). https://doi.org/10.1007/s10552-015-0682-5

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