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| Item Type: | Article |
|---|---|
| Title: | Therapy-related AML: long-term outcome in a large cohort of AML-patients with intensive and non-intensive therapy |
| Creators Name: | Gross, S., Ihlow, J., Busack, L., Adamiak, K., Schrezenmeier, J., Jesse, J., Schwarz, M., Flörcken, A., Vuong, L.G., Rieger, K., Krönke, J., le Coutre, P., Boldt, V., von Brünneck, A.C., Horst, D., Burmeister, T., Blau, I.W., Keller, U., Bullinger, L. and Westermann, J. |
| Abstract: | Therapy-related acute myeloid leukemia (t-AML) often exhibits adverse (genetic) features. There is ongoing discussion on the impact of t-AML on long-term outcome in AML. Therefore, we retrospectively analyzed clinical and biological characteristics of 1133 AML patients (225 t-AML patients and 908 de novo AML patients) with a median follow-up of 81.8 months. T-AML patients showed more adverse genetic alterations, higher age and more comorbidities as compared to de novo AML. Median OS in intensively treated t-AML patients was 13.7 months as compared to 39.4 months in de novo AML (p < 0.001). With non-intensive therapy, OS did not differ significantly (p = 0.394). With intensive therapy, significant differences in favor of de novo AML were observed in the ELN intermediate I/II (p = 0.009) and adverse (p = 0.016) risk groups but not within favorable risk groups (APL p = 0.927, ELN favorable p = 0.714). However, t-AML was no independent risk factor for OS (p = 0.103), RR (p = 0.982) and NRM (p = 0.320) in the multivariate analysis. A limitation of our study is an ELN 2010 risk stratification due to a lack of more comprehensive molecular data according to ELN 2022. We conclude that therapeutic algorithms in t-AML, in particular with regard to allo-HSCT, should be guided by ELN genetic risk rather than classification as t-AML alone. Our data support the WHO and ICC 2022 classifications, which include t-AML as diagnostic qualifier rather than a separate subcategory. |
| Keywords: | Antineoplastic Combined Chemotherapy Protocols, Follow-Up Studies, Acute Myeloid Leukemia, Second Primary Neoplasms, Prognosis, Retrospective Studies, Treatment Outcome |
| Source: | Blood Cancer Journal |
| ISSN: | 2044-5385 |
| Publisher: | Nature Publishing Group |
| Volume: | 14 |
| Number: | 1 |
| Page Range: | 160 |
| Date: | 16 September 2024 |
| Official Publication: | https://doi.org/10.1038/s41408-024-01140-5 |
| PubMed: | View item in PubMed |
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