Format

Send to

Choose Destination
Mult Scler. 2015 Apr;21(5):642-5. doi: 10.1177/1352458514541508. Epub 2014 Jul 10.

Therapy-related acute leukaemia with mitoxantrone: four years on, what is the risk and can it be limited?

Author information

1
The Walton Centre for Neurology and Neurosurgery, UK rjbellis@doctors.org.uk.
2
Countess of Chester, Chester, UK.
3
Townsville Hospital, Queensland, Australia.

Abstract

Therapy-related acute leukaemia (TRAL) is a significant concern, when considering treatment with mitoxantrone for multiple sclerosis (MS). We re-evaluated the literature, identifying all case reports and series of > 50 patients reporting TRAL cases in MS. TRAL was diagnosed in 0.73% of the 12,896 patients identified. Median onset was 22 months following treatment. We calculated a number needed to harm of 137.5 exposed patients, significantly higher than our 2008 analysis. We found that 82.8% of patients were exposed to > 60 mg/m(2) with a relative risk of 1.85 (p = 0.018) compared to < 60 mg/m(2), strongly suggesting a relationship to dose. MS treatment regimens which limit the mitoxantrone dose to < 60 mg/m(2) reduce the risk of TRAL.

KEYWORDS:

Adverse effects; disease-modifying therapies; dosage; leukemia; mitoxantrone; multiple sclerosis; relapsing-remitting multiple sclerosis; therapy-related acute leukemia

PMID:
25013152
DOI:
10.1177/1352458514541508
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center