Chemotherapy was one of the biggest life changing discoveries. It has prolonged the life expectancy of cancer patients. However, one of its complications is related to secondary neoplasm such as myelodysplastic syndrome (MDS).

This review's objective is to inform the health professionals the risk factors of one complication of the chemotherapy: secondary MSD. Condition that, even being rare, must be emphasized for having a great impact on life expectancy.

Literature revision. The databases used were PubMed, SciELO and Google Scholar. The terms used in the search were: “myelodysplastic syndrome”, “solid tumor”, “chemotherapy”.

Chemotherapy is related to therapy acute myeloid leukemia (tAML) and therapy related myelodysplastic syndrome (tMDS), which form a concept called therapy related myeloid neoplasm (t-MN). The prognosis of t-MN has an overall survival from 8 to 10 months. The t-MDS has been described in 0,08-0,83% of adverse events of chemotherapy depending on the solid tumor type. Approximately three-quarters of the cases happen in the first 5 years after the chemotherapy. Anticancer agents associated with the disease are alkylating agents and topoisomerase inhibitors (TI), agents used in 21% and 12 % of initial cancer therapy, respectively. Patients who receive alkylating agents can present with t-MDS, which often progresses rapidly to t-AML, but patients who receive TI usually present directly with t-AML. The risk of t-MN is associated with the drug doses, for example the incidence of t-MN in breast cancer patients in protocols of intensified and standard doses of cyclophosphamide was 1.01% and 0.21 %, respectively. The prevalence of t-MN is higher in young people. Furthermore, a population-based cohort study indicated elevated risk of t-MN after chemotherapy in 22 of the 23 solid tumors, colon being the exception. The site of the tumors that have more risks are bone/soft tissue, testicular and ovarian.

The risk factors of developing a tMDS must be evaluated after the treatment of a solid tumor. This information helps the physician to be more aware of some patients that have associated risk factors, like anticancer agents, chemotherapy doses, age and tumor site. In any patient postchemotherapy, it is needed to investigate when there is a clinical presentation of fatigue, infections, bruising or in the case of cytopenias, even in asymptomatic patients, a possible presentation of tMDS.