Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry
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‐A...
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| Veröffentlicht in: | American journal of hematology 2015, Vol.90 (3), p.208-214 |
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| creator | Hulegårdh, Erik Nilsson, Christer Lazarevic, Vladimir Garelius, Hege Antunovic, Petar Rangert Derolf, Åsa Möllgård, Lars Uggla, Bertil Wennström, Lovisa Wahlin, Anders Höglund, Martin Juliusson, Gunnar Stockelberg, Dick Lehmann, Sören |
| description | 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. © 2014 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/ajh.23908 |
| format | Article |
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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. 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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. © 2014 Wiley Periodicals, Inc.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Clinical Medicine</subject><subject>Female</subject><subject>Hematologi</subject><subject>Hematology</subject><subject>Humans</subject><subject>Klinisk medicin</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Leukemia, Myeloid, Acute - pathology</subject><subject>Lymphoma, Non-Hodgkin - drug therapy</subject><subject>Lymphoma, Non-Hodgkin - mortality</subject><subject>Lymphoma, Non-Hodgkin - pathology</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Neoplasms, Second Primary - drug therapy</subject><subject>Neoplasms, Second Primary - mortality</subject><subject>Neoplasms, Second Primary - pathology</subject><subject>Palliative Care</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Remission Induction</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Sweden</subject><issn>0361-8609</issn><issn>1096-8652</issn><issn>1096-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNk8uO0zAUQCMEYsrAgh9AltiwoDN-JU7YVeUxoEpIvLaWHd-07iRxxo5VlRWfwB_wb3wJ7mMGCWnQLCxf2eceX8u-WfaU4DOCMT1X69UZZRUu72UTgqtiWhY5vZ9NMCtIinF1kj0KYY0xIbzED7MTmnNKKCWT7Nd8pbyqR_D2uxqt65HqDRq8W_YujLZGDagxegjINShA7Xqj_BapOo6Aui20zhrUQryEzipkUzoa3BDbvev3j59aBTApcRxtv3yFZsjD4PyIGu86NK4Afd6AsWGFZnvj4tr0CZY2jH77OHvQqDbAk-N8mn19--bL_GK6-Pju_Xy2mK4FFuW0TjctQRBieCMMq0zFmagaLnQpCNMUuKGmrooCRKMNw2XTUFJTJnJqtK45O82mB2_YwBC1HLzt0kWlU1Yely5TBDInglci8Ytb-TYOaeg09gklcAVcSIINk5wDyHQglnljNMNaFA3RSffyVt1r-20mnV_KGGV65TJn_632L97FdCZhJbmb3vko84Lz4m761iY9KXK8418c-PRvriKEUXY21NC2qgcXg0yUYJQWeFfJ83_QtYu-T0-7o_Icl8W-3mdHKuoOzE0B1_82AecHYGNb2N7sEyx3DSFTQ8h9Q8jZh4t9wP4AS94Buw</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Hulegårdh, Erik</creator><creator>Nilsson, Christer</creator><creator>Lazarevic, Vladimir</creator><creator>Garelius, Hege</creator><creator>Antunovic, Petar</creator><creator>Rangert Derolf, Åsa</creator><creator>Möllgård, Lars</creator><creator>Uggla, Bertil</creator><creator>Wennström, Lovisa</creator><creator>Wahlin, Anders</creator><creator>Höglund, Martin</creator><creator>Juliusson, Gunnar</creator><creator>Stockelberg, Dick</creator><creator>Lehmann, Sören</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG8</scope><scope>D91</scope><scope>D93</scope><scope>DF2</scope><scope>D95</scope></search><sort><creationdate>2015</creationdate><title>Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry</title><author>Hulegårdh, Erik ; Nilsson, Christer ; Lazarevic, Vladimir ; Garelius, Hege ; Antunovic, Petar ; Rangert Derolf, Åsa ; Möllgård, Lars ; Uggla, Bertil ; Wennström, Lovisa ; Wahlin, Anders ; Höglund, Martin ; Juliusson, Gunnar ; Stockelberg, Dick ; Lehmann, Sören</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j7078-c3618e711d4f7d39d94379f47b8713b2e4d2dc966e7fbd308ff21c23752dbbc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Clinical Medicine</topic><topic>Female</topic><topic>Hematologi</topic><topic>Hematology</topic><topic>Humans</topic><topic>Klinisk medicin</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemia, Myeloid, Acute - pathology</topic><topic>Lymphoma, Non-Hodgkin - drug therapy</topic><topic>Lymphoma, Non-Hodgkin - mortality</topic><topic>Lymphoma, Non-Hodgkin - pathology</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>Neoplasms, Second Primary - drug therapy</topic><topic>Neoplasms, Second Primary - mortality</topic><topic>Neoplasms, Second Primary - pathology</topic><topic>Palliative Care</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Remission Induction</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Sweden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hulegårdh, Erik</creatorcontrib><creatorcontrib>Nilsson, Christer</creatorcontrib><creatorcontrib>Lazarevic, Vladimir</creatorcontrib><creatorcontrib>Garelius, Hege</creatorcontrib><creatorcontrib>Antunovic, Petar</creatorcontrib><creatorcontrib>Rangert Derolf, Åsa</creatorcontrib><creatorcontrib>Möllgård, Lars</creatorcontrib><creatorcontrib>Uggla, Bertil</creatorcontrib><creatorcontrib>Wennström, Lovisa</creatorcontrib><creatorcontrib>Wahlin, Anders</creatorcontrib><creatorcontrib>Höglund, Martin</creatorcontrib><creatorcontrib>Juliusson, Gunnar</creatorcontrib><creatorcontrib>Stockelberg, Dick</creatorcontrib><creatorcontrib>Lehmann, Sören</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Linköpings universitet</collection><collection>SWEPUB Örebro universitet</collection><collection>SWEPUB Umeå universitet</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Lunds universitet</collection><jtitle>American journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hulegårdh, Erik</au><au>Nilsson, Christer</au><au>Lazarevic, Vladimir</au><au>Garelius, Hege</au><au>Antunovic, Petar</au><au>Rangert Derolf, Åsa</au><au>Möllgård, Lars</au><au>Uggla, Bertil</au><au>Wennström, Lovisa</au><au>Wahlin, Anders</au><au>Höglund, Martin</au><au>Juliusson, Gunnar</au><au>Stockelberg, Dick</au><au>Lehmann, Sören</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry</atitle><jtitle>American journal of hematology</jtitle><addtitle>Am J Hematol</addtitle><date>2015</date><risdate>2015</risdate><volume>90</volume><issue>3</issue><spage>208</spage><epage>214</epage><pages>208-214</pages><issn>0361-8609</issn><issn>1096-8652</issn><eissn>1096-8652</eissn><abstract>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. © 2014 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25421221</pmid><doi>10.1002/ajh.23908</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols Breast Neoplasms - drug therapy Breast Neoplasms - mortality Breast Neoplasms - pathology Clinical Medicine Female Hematologi Hematology Humans Klinisk medicin Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Leukemia, Myeloid, Acute - pathology Lymphoma, Non-Hodgkin - drug therapy Lymphoma, Non-Hodgkin - mortality Lymphoma, Non-Hodgkin - pathology Male Medical and Health Sciences Medicin och hälsovetenskap Middle Aged Neoplasms, Second Primary - drug therapy Neoplasms, Second Primary - mortality Neoplasms, Second Primary - pathology Palliative Care Prognosis Registries Remission Induction Risk Factors Survival Analysis Sweden |
| title | Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry |
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