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
Issued Date
2022-12-01
Resource Type
ISSN
21522650
eISSN
21522669
Scopus ID
2-s2.0-85138580305
Pubmed ID
36117042
Journal Title
Clinical Lymphoma, Myeloma and Leukemia
Volume
22
Issue
12
Start Page
e1075
End Page
e1083
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Lymphoma, Myeloma and Leukemia Vol.22 No.12 (2022) , e1075-e1083
Suggested Citation
Chanswangphuwana C., Polprasert C., Owattanapanich W., Kungwankiattichai S., Tantiworawit A., Rattanathammethee T., Limvorapitak W., Saengboon S., Niparuck P., Puavilai T., Julamanee J., Saelue P., Wanitpongpun C., Nakhakes C., Prayongratana K., Sriswasdi C. 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. Clinical Lymphoma, Myeloma and Leukemia Vol.22 No.12 (2022) , e1075-e1083. e1083. doi:10.1016/j.clml.2022.08.010 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83527
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
Author's Affiliation
Other Contributor(s)
Abstract
Background: 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. Methods: The characteristics and real-world outcomes of sAML and AML-MRC from the Thai AML registry database were investigated. Results: 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). Conclusion: 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.