Reasons for treating secondary AML as de novo AML

Research output: Contribution to journalJournal articlepeer-review

  • Lene Sofie Granfeldt Ostgård
  • Eigil Kjeldsen
  • Mette Skov Holm
  • Brown, Peter de Nully
  • Bjarne Bach Pedersen
  • Knud Bendix
  • Preben Johansen
  • Jørgen Schøler Kristensen
  • Jan Maxwell Nørgaard
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.
Original languageEnglish
JournalEuropean Journal of Haematology
Volume85
Issue number3
Pages (from-to)217-26
Number of pages10
ISSN0902-4441
DOIs
Publication statusPublished - 1 Sep 2010

ID: 34128028