Treatment of therapy-related leukemia and myelodysplastic syndrome

The increasing incidence of therapy-related leukemia and myelodysplastic syndrome reflects (1) a longer period at risk resulting from successful treatment of solid tumors; (2) more intensive treatment regimens combining high-dose chemotherapy and irradiation; (3) broader utilization of adjuvant chemoirradiation in melanoma, colon, lung, breast, and head and neck cancers; and (4) environmental pollution and widespread exposure to chemicals and carcinogens in industrialized nations. The availability of novel therapies, including growth factors, has increased the referral of these patients to comprehensive cancer centers, partially explaining the increased awareness of the entity.