Introduction:

AML with myelodysplasia related changes (MRC) is a disease of elderly which has very poor outcome. There is limited data on survival disparities in AML with MRC by age and race.

Methods: We used SEER 18 registry to analyze relative survival (RS) rates among patients with AML with MRC diagnosed during 2000-2014. Patients were stratified by age (20-64 yrs, ≥65 yrs), sex and race (Caucasian, African American [ AA] and others). We used SEER Stat 8.3.4 for survival analysis.

Results: There were 2,071 patients; male 60%, median age of diagnosis 70 yrs; diagnosed with AML with MRC during 2000-2014. There were 1,742 Caucasian, 141 AA and 185 other races. The median overall survival of AML with MRC in Caucasian, AA and other races were 6.9, 6.1, 8.2 months respectively.

The RS for younger (20-64 yrs) patients was at 51.4% 1 yr , 32.8% 2 yr 27.9% and 3 yr . The RS for older patients was at 26.3% 1 yr , 12% 2 yr and 6.6% 3 yr .

When younger pts were analyzed by race, RS for Caucasian, AA, others were: 51.3%, 40.6%, 60.2% with p values 0.94, 0.104, 0.129 respectively at 1 yr ; 33.5%, 16.2%, 38.7% with p values 0.898, 0.017, 0.201 respectively at 3 years; 28.8%, 9.0%, 33.6% with p values 0.861, 0.005, 0.187 at 5 yrs respectively . There was no racial difference in RS in older patients.

When stratified by sex, RS for younger AA males vs all younger males were 33.4% vs 49.6% p: 0.05 at 1 yr; 11.6% vs 29.9% p 0.021 at 2 yrs ; and 3.9% vs 25% p 0.007 at 3 yrs respectively. There was no racial difference in RS in female sex both in younger and older patient population.

Conclusion:

Our study showed that young AA male diagnosed of AML with myelodysplasia related changes have poor outcome as compared to others. This difference is likely related to difference in disease biology and socio cultural differences and access to health care. Further studies are needed to identify potential areas of intervention.

Disclosures

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.

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