Reasons for treating secondary AML as de novo AML
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Reasons for treating secondary AML as de novo AML. / Ostgård, Lene Sofie Granfeldt; Kjeldsen, Eigil; Holm, Mette Skov; Brown, Peter De Nully; Pedersen, Bjarne Bach; Bendix, Knud; Johansen, Preben; Kristensen, Jørgen Schøler; Nørgaard, Jan Maxwell.
In: European Journal of Haematology, Vol. 85, No. 3, 01.09.2010, p. 217-26.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Reasons for treating secondary AML as de novo AML
AU - Ostgård, Lene Sofie Granfeldt
AU - Kjeldsen, Eigil
AU - Holm, Mette Skov
AU - Brown, Peter De Nully
AU - Pedersen, Bjarne Bach
AU - Bendix, Knud
AU - Johansen, Preben
AU - Kristensen, Jørgen Schøler
AU - Nørgaard, Jan Maxwell
PY - 2010/9/1
Y1 - 2010/9/1
N2 - In a Danish bi-regional registry-based study, we conducted an analysis of the incidence and clinical importance of secondary acute myeloid leukaemia (AML). In a total of 630 cases of AML, we found 157 (25%) cases of secondary AML. The secondary leukaemia arose from MDS (myelodysplastic syndrome) in 77 cases (49%), CMPD (chronic myeloproliferative disorder) in 43 cases (27%) and was therapy-related AML (t-AML) in 37 cases (24%). Median age at diagnosis of AML was 69 yr in secondary cases when compared to 66 yr in de novo cases (P = 0.006). In univariate analyses, secondary AML was associated with an inferior complete remission (CR) rate (P = 0.008) and poorer overall survival (OS, P = 0.003) whereas in complete remitters, disease-free survival (DFS) of secondary cases was equal to that of de novo cases. Interestingly, in all further analyses of CR-rates, OS and DFS, when correcting for the influence of age, cytogenetic abnormalities, performance status and leucocyte count (WBC), presence of secondary AML completely lost prognostic significance. We conclude that the presence of secondary AML does not per se convey an unfavourable prognosis and that patients with secondary AML should be offered the chance of benefiting from treatment according to current frontline AML protocols.
AB - In a Danish bi-regional registry-based study, we conducted an analysis of the incidence and clinical importance of secondary acute myeloid leukaemia (AML). In a total of 630 cases of AML, we found 157 (25%) cases of secondary AML. The secondary leukaemia arose from MDS (myelodysplastic syndrome) in 77 cases (49%), CMPD (chronic myeloproliferative disorder) in 43 cases (27%) and was therapy-related AML (t-AML) in 37 cases (24%). Median age at diagnosis of AML was 69 yr in secondary cases when compared to 66 yr in de novo cases (P = 0.006). In univariate analyses, secondary AML was associated with an inferior complete remission (CR) rate (P = 0.008) and poorer overall survival (OS, P = 0.003) whereas in complete remitters, disease-free survival (DFS) of secondary cases was equal to that of de novo cases. Interestingly, in all further analyses of CR-rates, OS and DFS, when correcting for the influence of age, cytogenetic abnormalities, performance status and leucocyte count (WBC), presence of secondary AML completely lost prognostic significance. We conclude that the presence of secondary AML does not per se convey an unfavourable prognosis and that patients with secondary AML should be offered the chance of benefiting from treatment according to current frontline AML protocols.
U2 - http://dx.doi.org/10.1111/j.1600-0609.2010.01464.x
DO - http://dx.doi.org/10.1111/j.1600-0609.2010.01464.x
M3 - Journal article
VL - 85
SP - 217
EP - 226
JO - European Journal of Haematology
JF - European Journal of Haematology
SN - 0902-4441
IS - 3
ER -
ID: 34128028