for madubois and those concerned about developing leukemia from the bc treatment...

[Lani]

it may not (just) be the chemotherapy that is responsible. Research seems to point towards a leukemogenic effect of radiation therapy--will try to read the whole article to see whether this effect is less with APBI than with whole breast radiation. The good news: they are getting ideas on how to prevent the secondary leukemia...

Cancer Res. 2007 Nov 1;67(21):10112-10116.
Local Radiotherapy Induces Homing of Hematopoietic Stem Cells to the Irradiated Bone Marrow.

Bastianutto C, Mian A, Symes J, Mocanu J, Alajez N, Sleep G, Shi W, Keating A, Crump M, Gospodarowicz M, Medin J, Minden M, Liu FF.
Departments of Medical Biophysics, Medicine, and Radiation Oncology, University of Toronto; Divisions of Applied Molecular Oncology and Stem Cell and Developmental Biology, Ontario Cancer Institute and Division of Medical Oncology and Department of Radiation Oncology, Princess Margaret Hospital, University Health Network.
Local breast radiation therapy (RT) is associated with a 3-fold increased risk of secondary acute myeloid leukemia. As a first step in determining the mechanism(s) underlying this observation, we investigated the role of RT in mediating the active recruitment of hematopoietic stem cells (HSC) to the site of RT. Our results show in a mouse model that local RT delivered to the left leg causes preferential accumulation of bone marrow mononuclear cells to the irradiated site, with maximum signal intensity observed at 7 days post-RT. This is associated with a 4-fold higher number of donor-derived HSC present in the left leg, demonstrating recruitment of HSC to the site of RT. SDF-1, matrix metalloproteinase 2 (MMP-2), and MMP-9 expression is significantly increased in the irradiated bone marrow, and their inhibition significantly reduced HSC recruitment to the irradiated bone marrow. Our data show that local RT has significant systemic effects by recruiting HSC to the irradiated bone marrow site, a process mediated by SDF-1, MMP-2, and MMP-9. These results raise the possibility that the exposure of increased numbers of HSC at a local site to fractionated irradiation may increase the risk of leukemogenesis. Our data also suggest some opportunities for leukemia prevention in breast cancer patients undergoing RT. [Cancer Res 2007;67(21):10112-6].
PMID: 17974951 [PubMed - as supplied by publisher]

[madubois63]

Thanks for posting and for thinking about me. In my case, I highly doubt radiation was the culprit, but it could have been a contributor along with several other factors in my lifetime. The doctors are pretty sure that it was the carboplaten (FOR ME). Anyone reading this that is currently on carbo, please do not think this will happen to you!!! It is extremely rare. I personally think it was a combination of things. I worked in the printing industry for over 20 years. A majority of the chemicals I used have benzene in them - which is a known cause of acute myeloid leukemia. Funny story (maybe you had to be there) - I am sound asleep in the hospital for my first round of leukemia chemo. A mans voice wakes me up, "DO YOU HAVE ACUTE MYELOID LEUKEMIA?" My eyes still closed and my mind still foggy, I answer him, "Yes??" "Did you work in the printing industry?," he asks. Again, I say, "Yes??" He then goes on to explain that many of the chemicals I used contained benzene - a known AML causing chemical. I am about to ask him who he is when I realize I fell asleep with the tv on and that he is telling me that I should use his company to sue...Geez, LOL. So besides the benzene, carbo and radiation, I was born and raised on land that was once a potato farm; and on the cancer map, my hometown has the highest incident of breast cancer in the country - yeah for me!! As for me, this is a little too late, but I would be VERY happy to know that no one else has to endure what I did...

[TSund]

Lani,

Did you read the specific info suggesting what exactly are the "opportunites for leukemia prevention in breast cancer patients undergoing RT"?

We are about to visit a 2nd radiologist at the end of this week and then Ruth will begin radiation after Thanksgiving.

TRS