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- Title
Characteristics and Outcomes of Secondary Acute Myeloid Leukemia and Acute Myeloid Leukemia With Myelodysplasia-Related Changes: Multicenter Study From the Thai Acute Leukemia Study Group.
- Authors
Chanswangphuwana, Chantiya; Polprasert, Chantana; Owattanapanich, Weerapat; Kungwankiattichai, Smith; Tantiworawit, Adisak; Rattanathammethee, Thanawat; Limvorapitak, Wasithep; Saengboon, Supawee; Niparuck, Pimjai; Puavilai, Teeraya; Julamanee, Jakrawadee; Saelue, Pirun; Wanitpongpun, Chinadol; Nakhakes, Chajchawan; Prayongratana, Kannadit; Sriswasdi, Chantrapa
- Abstract
<bold>Background: </bold>Secondary acute myeloid leukemia (sAML) and AML with myelodysplasia-related changes (AML-MRC) both result in dismal outcomes. This retrospective study aimed to determine whether these features are poor prognostic factors independent of older age and adverse cytogenetics, which are commonly associated with a poor prognosis.<bold>Methods: </bold>The characteristics and real-world outcomes of sAML and AML-MRC from the Thai AML registry database were investigated.<bold>Results: </bold>From a total of 992 newly diagnosed AML patients, 315 (31.8%) patients were classified into sAML or AML-MRC subtypes. Older age, low white blood cell (WBC) count, low bone marrow blast, and adverse cytogenetic risk were commonly present in sAML and AML-MRC compared to de novo AML. Complete remission after 7 + 3 induction therapy occurred in 42.3% of patients with sAML or AML-MRC and 62.4% of de novo AML (P < .001). The median overall survival (OS) of sAML, AML-MRC, and de novo AML were 6.9, 7.0, and 12.2 months, respectively (P < .001). The independent prognostic factors for inferior OS were older age, intermediate-risk or adverse-risk cytogenetics, WBC count > 100 × 109/L, poor performance status, and a subgroup of AML-MRC with the morphologic criteria of multilineage dysplasia (AML-MRC-M). In addition, sAML, AML-MRC, and a WBC count > 100 × 109/L were pre-treatment prognostic factors associated with poor relapse-free survival (P = .006, P = .017, and P < .001, respectively).<bold>Conclusion: </bold>Both sAML and AML-MRC are independently associated with poor outcomes in Thai patients. Our study supports AML-MRC-M as an adverse prognostic factor for OS.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2022, Vol 22, Issue 12, pe1075
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2022.08.010