What is the role of an antecedent hematologic disorder (AHD) in the etiology of acute lymphoblastic leukemia (ALL)?

Updated: Feb 20, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Rare patients have an antecedent hematologic disorder (AHD) such as myelodysplastic syndrome (MDS) that evolves to ALL. However, most patients with MDS that evolves to acute leukemia develop AML rather than ALL. Some patients receiving lenalidomide as maintenance therapy for multiple myeloma have developed secondary ALL. [4]  In a study of the California Cancer Registry it was noted that 3% of patients had a prior known malignancy and that any prior malignancy predisposed to the development of ALL. The prognosis for these patients with secondary ALL was unfavorable compared with that of patients with de novo ALL. [5]

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