Consideration of the risk of secondary leukemia after mitoxantrone in multiple sclerosis populations is required
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Medical Update Memo
October 27, 2009
Summary
Mitoxantrone is one of the accepted treatments for MS, although its use is restricted to people who do not have a good response to first line therapies such as interferon beta and glatiramer acetate, because of its potentially life threatening side effects including acute leukaemia. The risk of acute leukaemia after mitoxantrone treatment is not yet fully understood. Mult Scler. 2009 Oct 13 epub ahead of print
Details
The authors aimed to evaluate the real incidence of this life threatening event in two cohorts of people with MS who received this treatment. After a mean follow-up of between three and four years after treatment discontinuation, they found that, the accumulated incidence of acute leukaemia was higher than 2%. This percentage was higher than what had been reported in previous studies. They did not find any relation between the appearance of acute leukaemia and the dose administered, age at disease onset or at the beginning of mitoxantrone treatment, disease duration, sex or the presence of other treatments. The authors concluded that the real incidence of acute myeloid leukaemia after mitoxantrone therapy in the multiple sclerosis population could be higher as evidenced by the growing number of cases reported and that people who received mitoxantrone should be monitored for at least five years after treatment discontinuation.
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Disclaimer
The Multiple Sclerosis Society of Canada is an independent, voluntary health
agency and does not approve, endorse or recommend any specific product or therapy,
but provides information to assist individuals in making their own decisions.
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