Cancer treatment may also cause secondary malignant neoplasms. Which agent has been linked to later development of Acute Myeloid Leukemia (AML) and myelodysplastic syndrome (MDS)?

Prepare for the CPHON Chemotherapy Test with interactive materials. Use flashcards and multiple choice questions with hints and explanations. Get exam-ready!

Therapy-related leukemias are a known late complication of certain chemotherapy drugs. Etoposide is a topoisomerase II inhibitor; it can cause DNA double-strand breaks. If these breaks are misrepaired, they create chromosomal rearrangements, commonly involving the 11q23/MLL region, which are characteristic findings in therapy-related AML and, less often, in myelodysplastic syndrome. Because of this mechanism, exposure to etoposide has been linked to developing AML/MDS years after treatment, typically within a shorter latency window than some other agents. While alkylating agents like cyclophosphamide or ifosfamide can also lead to therapy-related AML/MDS, they usually do so after a longer period and with different cytogenetic patterns. So, etoposide best fits the described association.