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Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry

Hulegardh, Erik; Nilsson, Christer; Lazarevic, Vladimir LU ; Garelius, Hege; Antunovic, Petar; Rangert Derolf, Asa; Mollgard, Lars; Uggla, Bertil; Wennstrom, Lovisa and Wahlin, Anders, et al. (2015) In American Journal of Hematology 90(3). p.208-214
Abstract
Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable... (More)
Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients. Am. J. Hematol. 90:208-214, 2015. (c) 2014 Wiley Periodicals, Inc. (Less)
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American Journal of Hematology
volume
90
issue
3
pages
208 - 214
publisher
John Wiley & Sons
external identifiers
  • wos:000349889300014
  • scopus:84923114820
ISSN
0361-8609
DOI
10.1002/ajh.23908
language
English
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yes
id
58e4ae47-10d3-44ee-bc40-5fdb30b76f1b (old id 5305120)
date added to LUP
2015-05-04 08:38:46
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2017-11-05 03:05:13
@article{58e4ae47-10d3-44ee-bc40-5fdb30b76f1b,
  abstract     = {Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients. Am. J. Hematol. 90:208-214, 2015. (c) 2014 Wiley Periodicals, Inc.},
  author       = {Hulegardh, Erik and Nilsson, Christer and Lazarevic, Vladimir and Garelius, Hege and Antunovic, Petar and Rangert Derolf, Asa and Mollgard, Lars and Uggla, Bertil and Wennstrom, Lovisa and Wahlin, Anders and Hoglund, Martin and Juliusson, Gunnar and Stockelberg, Dick and Lehmann, Soren},
  issn         = {0361-8609},
  language     = {eng},
  number       = {3},
  pages        = {208--214},
  publisher    = {John Wiley & Sons},
  series       = {American Journal of Hematology},
  title        = {Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry},
  url          = {http://dx.doi.org/10.1002/ajh.23908},
  volume       = {90},
  year         = {2015},
}