Chronic Myeloid Leukemia Following Treatment for Primary Neoplasms or Other Medical Conditions

A Report of 21 Cases and Review of the Literature

Lian-He Yang, MD, PhD; Pu Su, MD, PhD; Catherine Luedke, MD; Chuanyi Mark Lu, MD; Abner Louissaint Jr, MD, PhD; Chad M. McCall, MD, PhD; Sarah Rapisardo, PhD; Bethany Vallangeon, MD; Endi Wang, MD, PhD


Am J Clin Pathol. 2018;150(3):246-258. 

In This Article

Materials and Methods

Case Selection

Following approval of the study by the institutional review board of Duke University Medical Center, we retrieved cases of therapy-related CML from our pathology database for the past 13 years. Twelve cases were from Duke University Medical Center and the remaining nine cases were from collaborating academic institutions, including Massachusetts General Hospital (n = 6) and the University of California San Francisco Medical Center (n = 3). All the cases were retrospectively evaluated by three hematopathologists (C.M.L., A.L., and E.W.), and the diagnosis of each individual case was confirmed according to the World Health Organization classification of tumors of hematopoietic and lymphoid tissues.[1,2] Clinical histories and laboratory data, including flow cytometric analyses, cytogenetic studies, and molecular diagnostic tests, were collected and retrospectively reviewed and analyzed.

Literature Review

A PubMed literature search was performed using relevant title words, such as "chronic myelogenous leukemia" or "chronic myeloid leukemia," "therapy-related," "following" or "after," and "secondary." Previously published cases of therapy-related CML were reviewed, collected, and analyzed.

Statistical Analysis

Statistical analyses were performed with IBM SPSS Statistics, version 22 ( Overall survival was calculated using Kaplan-Meier survival analysis, generating the estimated median survival and a 95% confidence interval.