A new analysis indicates that certain characteristics may indicate a higher risk of developing leukemia after chemotherapy and/or radiation for breast cancer survivors. Published in CANCER (doi:10.1002/cncr.29615), the findings are a first step toward finding ways to prevent this serious and potentially life-threatening treatment-related complication.

Certain targeted cancer treatments can also affect normal, healthy cells, potentially increasing a patient’s risk of later developing leukemia. Breast cancer survivors now account for most cases of therapy-related leukemia.

To investigate, a team led by Jane Churpek, MD, of The University of Chicago, examined the characteristics of 88 breast cancer survivors with therapy-related leukemia.

They found that breast cancer survivors who develop therapy-related leukemia often have personal and family histories suggestive of inherited cancer susceptibility. Also, 1 in 5 of the women in the study carried an inherited mutation in a gene associated with an increased risk of breast cancer.


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“The findings justify a long-term follow-up study of women with and without inherited breast cancer gene mutations who are treated with similar therapy for breast cancer. This would enable us to understand how these genes impact therapy-related leukemia risk and whether specific treatments come with higher risks based on a woman’s inherited genetics,” said Churpek. She noted that this knowledge would help doctors have more individualized conversations about the potential risks versus benefits of initial treatments for breast cancer.

In an accompanying editorial (doi:10.1002/cncr.29613), Judith Karp, MD, and Antonio Wolff, MD, of the Johns Hopkins University School of Medicine in Baltimore, Maryland, noted that it can be difficult to determine what constitutes therapy-related leukemia and what may be a second malignancy unrelated to a patient’s treatment.

“Existing familial cancer registries that are prospectively following breast cancer patients and their families are uniquely positioned to ascertain the true frequency of subsequent leukemias and their associations with the therapies received and the known germline genetic alterations,” they wrote.