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Secondary Acute Myeloid Leukemia (sAML): Similarly Dismal Outcomes of AML After an Antecedent Hematologic Disorder and Therapy Related AML.

Authors :
Lalayanni C
Gavriilaki E
Athanasiadou A
Iskas M
Papathanasiou M
Marvaki A
Mpesikli S
Papaioannou G
Mallouri D
Batsis I
Papalexandri A
Sakellari I
Anagnostopoulos A
Source :
Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2022 Apr; Vol. 22 (4), pp. e233-e240. Date of Electronic Publication: 2021 Oct 01.
Publication Year :
2022

Abstract

Therapy related acute myeloid leukemia (tAML) and secondary AML after an antecedent hematologic disorder (sAML-AHD) are often addressed together, blurring any clinical and prognostic differences. Among 516 AML patients, we compared characteristics and outcomes of 149 patients with "sAML" (sAML-AHD: 104, tAML: 45), uniformly and intensively treated during the last 2 decades at 1 center. Clinical outcomes of the whole "sAML" cohort were significantly inferior compared to de novo AML and in both intermediate and poor cytogenetic risk groups. Adverse karyotype had no effect on survival in tAML, while it was a negative predictor in sAML-AHD. Both groups showed similarly dismal outcome, with low complete remission rates (CR 44% vs. 41%) and median overall survival (OS 7 vs. 10.5 months). Allogeneic hematopoietic cell transplantation (alloHCT) recipients in CR1 had superior median OS (24 vs. 8 months). By multivariate analysis, alloHCT was an independent predictor of outcome, while karyotype was for sAML-AHD only. In conclusion, both "sAML" groups have inferior outcomes after chemotherapy, with adverse karyotype affecting primarily sAML-AHD. Until new treatment approaches are available, only alloHCT offers a survival advantage.<br /> (Copyright © 2021. Published by Elsevier Inc.)

Details

Language :
English
ISSN :
2152-2669
Volume :
22
Issue :
4
Database :
MEDLINE
Journal :
Clinical lymphoma, myeloma & leukemia
Publication Type :
Academic Journal
Accession number :
34756570
Full Text :
https://doi.org/10.1016/j.clml.2021.09.019