Treatment patterns and outcomes of 2310 patients with secondary acute myeloid leukemia: a PETHEMA registry study.

Abstract

Secondary acute myeloid leukemia (sAML) comprises a heterogeneous group of patients and is associated with poor overall survival (OS). We analyze the characteristics, treatment patterns, and outcomes of adult patients with sAML in the Programa Español de Tratamientos en Hematología (PETHEMA) registry. Overall, 6211 (72.9%) were de novo and 2310 (27.1%) had sAML, divided into myelodysplastic syndrome AML (MDS-AML, 44%), MDS/myeloproliferative AML (MDS/MPN-AML, 10%), MPN-AML (11%), therapy-related AML (t-AML, 25%), and antecedent neoplasia without prior chemotherapy/radiotherapy (neo-AML, 9%). Compared with de novo, patients with sAML were older (median age, 69 years), had more Eastern Cooperative Oncology Group ≥2 (35%) or high-risk cytogenetics (40%), less FMS-like tyrosine kinase 3 internal tandem duplication (11%), and nucleophosmin 1 (NPM1) mutations (21%) and received less intensive chemotherapy regimens (38%) (all P < .001). Median OS was higher for de novo than sAML (10.9 vs 5.6 months; P < .001) and shorter in sAML after hematologic disorder (MDS, MDS/MPN, or MPN) compared with t-AML and neo-AML (5.3 vs 6.1 vs 5.7 months, respectively; P = .04). After intensive chemotherapy, median OS was better among patients with de novo and neo-AML (17.2 and 14.6 months, respectively). No OS differences were observed after hypomethylating agents according to type of AML. sAML was an independent adverse prognostic factor for OS. We confirmed high prevalence and adverse features of sAML and established its independent adverse prognostic value. This trial was registered at www.clinicaltrials.gov as #NCT02607059.

• Authors: David Martínez-Cuadrón, Juan E Megías-Vericat, Josefina Serrano, Pilar Martínez-Sánchez, Eduardo Rodríguez-Arbolí, Cristina Gil, Eliana Aguiar, Juan Bergua, José L López-Lorenzo, Teresa Bernal, Ana Espadana, Mercedes Colorado, Carlos Rodríguez-Medina, María López-Pavía, Mar Tormo, Lorenzo Algarra, María-Luz Amigo, María J Sayas, Jorge Labrador, Juan I Rodríguez-Gutiérrez, Celina Benavente, Lissette Costilla-Barriga, Raimundo García-Boyero, Esperanza Lavilla-Rubira, Susana Vives, Pilar Herrera, Daniel García-Belmonte, María Mar Herráez, Graça Vasconcelos Esteves, Maria I Gómez-Roncero, Ana Cabello, Guiomar Bautista, Amaia Balerdi, José Mariz, Blanca Boluda, Miguel Á Sanz, Pau Montesinos
• Journal: Blood advances (Blood Adv) Vol. 6 Issue 4 Pg. 1278-1295 (02 22 2022) ISSN: 2473-9537 [Electronic] United States
• PMID: 34794172 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.

Topics

• Adult
• Aged
• Humans
• Leukemia, Myeloid, Acute (diagnosis, drug therapy, etiology)
• Myelodysplastic Syndromes (therapy)
• Neoplasms, Second Primary (epidemiology, etiology)
• Registries
• Remission Induction