Characterization of therapy-related acute myeloid leukemia : increasing incidence and prognostic implications
(2023) In Haematologica 108(4). p.1015-1025- Abstract
Studies of therapy-related AML (t-AML) are usually performed in selected cohorts and reliable incidence rates are lacking. In this study, we characterized, defined the incidence over time and studied prognostic implications in all t-AML patients diagnosed in Sweden between 1997 and 2015. Data were retrieved from nationwide population-based registries. In total, 6,779 AML patients were included in the study, of whom 686 (10%) had t-AML. The median age for t-AML was 71 years and 392 (57%) patients were females. During the study period, the incidence of t-AML almost doubled with a yearly increase in t-AML of 4.5% (95% confidence interval: 2.8%-6.2%), which contributed significantly to the general increase in AML incidence over the study... (More)
Studies of therapy-related AML (t-AML) are usually performed in selected cohorts and reliable incidence rates are lacking. In this study, we characterized, defined the incidence over time and studied prognostic implications in all t-AML patients diagnosed in Sweden between 1997 and 2015. Data were retrieved from nationwide population-based registries. In total, 6,779 AML patients were included in the study, of whom 686 (10%) had t-AML. The median age for t-AML was 71 years and 392 (57%) patients were females. During the study period, the incidence of t-AML almost doubled with a yearly increase in t-AML of 4.5% (95% confidence interval: 2.8%-6.2%), which contributed significantly to the general increase in AML incidence over the study period. t-AML solidly constituted over 10% of all AML cases during the later period of the study. Primary diagnoses with the largest increase in incidence and decrease in mortality rate during the study period (i.e., breast and prostate cancer) contributed significantly to the increased incidence of t-AML. In multivariable analysis, t-AML was associated with poorer outcome in cytogenetically intermediate- and adverse-risk cases but t-AML had no significant impact on outcome in favorable-risk AML, including core binding leukemias, acute promyelocytic leukemia and AML with mutated NPM1 without FLT3-ITD. We conclude that there is a strong increase in incidence in t-AML over time and that t-AML constitutes a successively larger proportion of the AML cases. Furthermore, we conclude that t-AML confers a poor prognosis in cytogenetically intermediate- and adverse-risk, but not in favorable-risk AML.
(Less)
- author
- organization
- publishing date
- 2023-04
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Haematologica
- volume
- 108
- issue
- 4
- pages
- 1015 - 1025
- publisher
- Ferrata Storti Foundation
- external identifiers
-
- scopus:85146089639
- pmid:36005563
- ISSN
- 0390-6078
- DOI
- 10.3324/haematol.2022.281233
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: The study was supported by the Swedish Cancer Foundation, Swedish Research Council and Stockholm County Council. Publisher Copyright: ©2023 Ferrata Storti Foundation Published under a CC BY-NC license.
- id
- c3dbf486-6b87-4bc2-951f-ff44d2604805
- date added to LUP
- 2023-04-17 06:30:52
- date last changed
- 2024-06-15 01:56:36
@article{c3dbf486-6b87-4bc2-951f-ff44d2604805,
abstract = {{<p>Studies of therapy-related AML (t-AML) are usually performed in selected cohorts and reliable incidence rates are lacking. In this study, we characterized, defined the incidence over time and studied prognostic implications in all t-AML patients diagnosed in Sweden between 1997 and 2015. Data were retrieved from nationwide population-based registries. In total, 6,779 AML patients were included in the study, of whom 686 (10%) had t-AML. The median age for t-AML was 71 years and 392 (57%) patients were females. During the study period, the incidence of t-AML almost doubled with a yearly increase in t-AML of 4.5% (95% confidence interval: 2.8%-6.2%), which contributed significantly to the general increase in AML incidence over the study period. t-AML solidly constituted over 10% of all AML cases during the later period of the study. Primary diagnoses with the largest increase in incidence and decrease in mortality rate during the study period (i.e., breast and prostate cancer) contributed significantly to the increased incidence of t-AML. In multivariable analysis, t-AML was associated with poorer outcome in cytogenetically intermediate- and adverse-risk cases but t-AML had no significant impact on outcome in favorable-risk AML, including core binding leukemias, acute promyelocytic leukemia and AML with mutated NPM1 without FLT3-ITD. We conclude that there is a strong increase in incidence in t-AML over time and that t-AML constitutes a successively larger proportion of the AML cases. Furthermore, we conclude that t-AML confers a poor prognosis in cytogenetically intermediate- and adverse-risk, but not in favorable-risk AML.</p>}},
author = {{Nilsson, Christer and Linde, Fredrika and Hulegårdh, Erik and Garelius, Hege and Lazarevic, Vladimir and Antunovic, Petar and Cammenga, Jörg and Deneberg, Stefan and Jädersten, Martin and Björkvall, Cecilia Kämpe and Möllgård, Lars and Wennström, Lovisa and Ölander, Emma and Juliusson, Gunnar and Lehmann, Sören}},
issn = {{0390-6078}},
language = {{eng}},
number = {{4}},
pages = {{1015--1025}},
publisher = {{Ferrata Storti Foundation}},
series = {{Haematologica}},
title = {{Characterization of therapy-related acute myeloid leukemia : increasing incidence and prognostic implications}},
url = {{http://dx.doi.org/10.3324/haematol.2022.281233}},
doi = {{10.3324/haematol.2022.281233}},
volume = {{108}},
year = {{2023}},
}