Quimioterapia como fator de risco para o desenvolvimento de síndrome mielodisplásica secundária: revisão integrativa

Abstract

Myelodysplastic syndromes (MDS) are characterized as a group of clonal neoplasm of the bone marrow that exhibits ineffective hematopoiesis with morphological dysplasia in hematopoietic cells and peripheral cytopenia. MDS cases can be categorized as de novo, when attributed from primary sources without previous events, and as secondary, when developed after some known mutagenic event, such as therapy-related MDS (t-MDS). This integrative review, with articles from 2012 to 2022, gathered information about t-MDS and chemotherapy such as: risk factors, types of cancers and incidence. It has been observed that the incidence of t-MDS increases as cancer treatments advance and there is better adherence to treatment. Furthermore, the relationship of chemotherapy is well established as a cause of t-MDS, which is aggravated when chemotherapy and radiotherapy are used together. It was possible to observe that patients with breast, lung, endometrial, cervical and lymphoma cancer had a higher incidence of t-MDS after chemotherapy treatment. Thus, current treatments for cancers must be performed based on a risk-benefit analysis for the patient, considering the possible consequence of the appearance of hematological neoplasms. Future studies with larger patient samples and specific information on treatment and disease subgroup are needed to assess the associations predicted in this work.