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       #Post#: 701--------------------------------------------------
       (Abst.) Therapy-related acute leukemia w/Novantrone...limiting t
       he risk
       By: agate Date: March 30, 2015, 9:54 am
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       From Multiple Sclerosis Journal, March 30, 2015:
       [quote]Therapy-related acute leukaemia with mitoxantrone: Four
       years on, what is the risk and can it be limited?
       Richard Ellis
       The Walton Centre for Neurology and Neurosurgery, UK
       Sean Brown
       Countess of Chester, Chester, UK
       Mike Boggild
       Townsville Hospital, Queensland, Australia
       The Walton Centre for Neurology and Neurosurgery, Lower Lane,
       Fazakerley, Liverpool, L9 7LJ, UK rjbellis@doctors.org.uk
       Therapy-related acute leukaemia (TRAL) is a significant concern,
       when considering treatment with mitoxantrone for multiple
       sclerosis (MS). We re-evaluated the literature, identifying all
       case reports and series of > 50 patients reporting TRAL cases in
       MS. TRAL was diagnosed in 0.73% of the 12,896 patients
       identified. Median onset was 22 months following treatment. We
       calculated a number needed to harm of 137.5 exposed patients,
       significantly higher than our 2008 analysis.
       We found that 82.8% of patients were exposed to > 60 mg/m2 with
       a relative risk of 1.85 (p = 0.018) compared to < 60mg/m2,
       strongly suggesting a relationship to dose. MS treatment
       regimens which limit the mitoxantrone dose to < 60mg/m2 reduce
       the risk of TRAL.[/quote]
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