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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
Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden; Reg Tumor Registry, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
Hematol Ctr, Huddinge Karolinska Univ Hosp, Stockholm, Sweden; Reg Tumor Registry, Stockholm, Sweden.ORCID iD: 0000-0003-0695-0050
Dept Hematol, Skåne Univ Hosp, Lund, Sweden; Reg Tumor Registry, Skåne Univ Hosp, Lund, Sweden; Lund Univ, Lund, Sweden; Swedish Acute Myeloid Leukemia Grp, Linköping Univ Hosp, Linköping, Sweden.
Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden; Reg Tumor Registry, Sahlgrenska Univ Hosp, Gothenburg, Sweden; Swedish Acute Myeloid Leukemia Grp, Linköping Univ Hosp, Linköping, Sweden.
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2015 (English)In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 90, no 3, p. 208-214Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 90, no 3, p. 208-214
National Category
Hematology
Identifiers
URN: urn:nbn:se:oru:diva-56446DOI: 10.1002/ajh.23908ISI: 000349889300014PubMedID: 25421221Scopus ID: 2-s2.0-84923114820OAI: oai:DiVA.org:oru-56446DiVA, id: diva2:1082380
Funder
Swedish Cancer Society
Note

Funding Agency:

Stockholm County Council

Note:

Authors on behalf of the Swedish Acute Myeloid Leukemia Grp (in this document): V. Lazarevic, H. Garelius, P. Antunovic, Å. Rangert Derolf, L. Mollgard, L.Wennström, A. Wahlin, M. Höglund, G. Juliusson, D. Stockelberg, S. Lehmann

Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2018-08-30Bibliographically approved

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