Which of the following agents is most likely to cause a secondary malignancy?

Changes in chemotherapy protocols have influenced the risk and rate of secondary malignancies in high-risk populations. The alkylating agents, topoisomerase inhibitors, and anthracycline agents pose the highest risk of initiating carcinogenesis.

What causes secondary malignancy?

Secondary malignancies are cancers caused by treatment with radiation or chemotherapy. They are unrelated to the first cancer that was treated, and may occur months or even years after initial treatment.

What Chemo can cause secondary malignancy?

Chemotherapy agents that have an increased risk for second cancers include:

  • Alkylating agents (mechlorethamine, chlorambucil, cyclophosphamide, melphalan, lomustine, carmustine, busulfan)
  • Platinum-based drugs (cisplatin, carboplatin)

How do alkylating agents cause secondary malignancies?

Alkylating Agent–Induced Leukemias

Alkylating agents induce dose-limiting myelosuppression and cause sublethal DNA damage to hematopoietic progenitors, causing mutational events that lead to malignant transformation to preleukemic and leukemic states.

What secondary malignant is commonly associated with radiation therapy?

Ionizing Radiation

Bone and soft-tissue sarcomas are the most frequent SMNs following radiation therapy, but skin, brain, thyroid, and breast cancers also can occur. Radiation doses less than 30 Gy tend to be associated with thyroid and brain tumors, whereas doses greater than 30 Gy can evoke secondary sarcomas.

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How common are second cancers?

Second cancers are becoming more common since more people are living longer after their first cancer diagnosis than ever before. About 1 in every 6 people diagnosed with cancer has had a different type of cancer in the past.

What is secondary malignant neoplastic?

Secondary malignant neoplasm is a malignant tumor whose cause is the treatment (usually radiation or chemotherapy) which was used for a prior tumor. It must be distinguished from Metastasis from the prior tumor or a relapse from it since a secondary malignant neoplasm is a different tumor.

Can alkylating agents cause leukemia?

In rare cases, this can lead to leukemia. The risk of leukemia from alkylating agents is “dose-dependent,” meaning that the risk is small with lower doses, but goes up as the total amount of the drug used gets higher. The risk of leukemia after getting alkylating agents is highest about 5 to 10 years after treatment.

Why does chemo cause leukemia?

A person’s bone marrow stem cells can be damaged by cancer treatments known as alkylating agents, the first class of chemotherapy agents used. These agents increase the risk for myelodysplastic syndrome or AML. In some cases, myelodysplastic syndrome develops and later transforms into AML.

What is radiation induced leukemia?

From Wikipedia, the free encyclopedia. Exposure to ionizing radiation is known to increase the future incidence of cancer, particularly leukemia. The mechanism by which this occurs is well understood, but quantitative models predicting the level of risk remain controversial.

Which of the following chemotherapeutic agents is associated with secondary leukemia?

Drugs that induce secondary leukemias comprise alkylating agents, like cyclophosphamide, topoisomerase II inhibitors, including epipodophylotoxins (etoposide, teniposide), and anthracyclinic agents, like doxorubicin.

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Who makes vincristine?

“Pfizer is now the only supplier of vincristine and we are committed to providing this important medicine to patients,” the company stated on its website.

What do topoisomerase inhibitors do?

Topoisomerase inhibitors block the ligation step of the cell cycle, which generates DNA single- and double-strand breaks, leading to apoptotic cell death. Topoisomerase I inhibitors include irinotecan, topotecan, and camptothecin, and topoisomerase II inhibitors include etoposide, doxorubicin, and epirubicin.