Abstract 3117

Poster Board III-54

Differences in the clinical course of secondary acute myeloid leukemia (s-AML) according to the type of the preceding disorders are not defined. We compared the outcomes of therapy-related AML (t-AML), AML following myelodysplastic syndrome (MDS-AML) and AML following myeloproliferative disorder (MPD-AML). We also intended to find prognostic factors in s-AML overall.

Retrospective medical record review at Seoul National University Hospital was performed. We assessed response to induction chemotherapy and overall survival (OS).

95 s-AML patients (median age 56.4 years) were analyzed. 26, 57 and 12 patients had t-AML, MDS-AML and MPD-AML respectively. For patients receiving induction chemotherapy, complete remission (CR) rate was 47.5% and CR rate was different according to the type of the preceding disorders (p=0.004). Compared to t-AML (p=0.027) and MDS-AML (p=0.050), MPD-AML had shorter OS. In s-AML, presence of trisomy 8 had a prognostic impact (p=0.003) along with cytogenetic risk group (p=0.016). In multivariate analysis, the type of the preceding disorders (p=0.026), 5q deletion (p=0.015) and trisomy 8 (p=0.040) were independent prognostic factors.

In conclusion, prognosis of s-AML was different according to the type of the preceding disorders with the worst prognosis in MPD-AML. Along with cytogenetic risk grouping, trisomy 8 had a prognostic impact in s-AML.

Table 1

Characteristics of s-AML patients according to preceding disorders

Characteristicst-AMLAML-MDSAML-MPDp-value
Age (median) 54.1 57.2 65.5 0.888 
Gender    0.262 
Male 13 39 8  
Female 13 18 4  
Latency period 31.2 6.7 92.6 0.008 
White blood cell (median) (/μL) 5615 2905 12785 0.002 
Hemoglobin (median) (g/dL) 8.0 8.4 8.7 0.543 
Platelet (median) (/μL) 51500 32000 100500 0.509 
Risk group    0.001 
Favorable 6 0 0  
Intermediate 12 37 10  
Poor 5 12 2  
5q deletion    0.731 
Present 5 7 2  
Absent 18 42 10  
-7/7q deletion    0.107 
Present 1 11 1  
Absent 22 38 11  
Trisomy 8    0.777 
Present 6 13 2  
Absent 18 36 10  
Induction chemotherapy    0.619 
Yes 23 47 11  
No 3 10 1  
Complete remission after induction    0.004 
Yes 17 19 2  
No 6 27 9  
Stem cell transplantation    0.137 
Yes 9 4 1  
No 8 15 2  
Characteristicst-AMLAML-MDSAML-MPDp-value
Age (median) 54.1 57.2 65.5 0.888 
Gender    0.262 
Male 13 39 8  
Female 13 18 4  
Latency period 31.2 6.7 92.6 0.008 
White blood cell (median) (/μL) 5615 2905 12785 0.002 
Hemoglobin (median) (g/dL) 8.0 8.4 8.7 0.543 
Platelet (median) (/μL) 51500 32000 100500 0.509 
Risk group    0.001 
Favorable 6 0 0  
Intermediate 12 37 10  
Poor 5 12 2  
5q deletion    0.731 
Present 5 7 2  
Absent 18 42 10  
-7/7q deletion    0.107 
Present 1 11 1  
Absent 22 38 11  
Trisomy 8    0.777 
Present 6 13 2  
Absent 18 36 10  
Induction chemotherapy    0.619 
Yes 23 47 11  
No 3 10 1  
Complete remission after induction    0.004 
Yes 17 19 2  
No 6 27 9  
Stem cell transplantation    0.137 
Yes 9 4 1  
No 8 15 2  
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Figure 1
Figure 1. CR-1 (A) and OS (B) according to preceding disorders CR-1 was not affected by preceding disorders, however OS was significantly the shorter in AML evolving from MPD (black line) compared to AML evolving from MDS (orange line) and t-AML (green line).
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CR-1 (A) and OS (B) according to preceding disorders CR-1 was not affected by preceding disorders, however OS was significantly the shorter in AML evolving from MPD (black line) compared to AML evolving from MDS (orange line) and t-AML (green line).

Figure 1
Figure 1. CR-1 (A) and OS (B) according to preceding disorders CR-1 was not affected by preceding disorders, however OS was significantly the shorter in AML evolving from MPD (black line) compared to AML evolving from MDS (orange line) and t-AML (green line).
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CR-1 (A) and OS (B) according to preceding disorders CR-1 was not affected by preceding disorders, however OS was significantly the shorter in AML evolving from MPD (black line) compared to AML evolving from MDS (orange line) and t-AML (green line).

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Disclosures

No relevant conflicts of interest to declare.

Topics:
hematological diseases, leukemia, secondary acute, trisomy 8, chemotherapy, neoadjuvant, complete remission, prognostic factors, hematopoietic stem cell transplantation, hemoglobin, myelodysplastic syndrome, myeloproliferative disease

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2009 by The American Society of Hematology
2009
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