title: Prognosis of secondary acute myeloid leukemia is affected by the type of the preceding hematologic disorders and the presence of trisomy 8.
abstract: BACKGROUND
  Differences in the clinical course of secondary acute myeloid leukemia according to the type of the preceding disorders are not defined. We compared the outcomes of therapy-related acute myeloid leukemia, acute myeloid leukemia following myelodysplastic syndrome and acute myeloiod leukemia following myeloproliferative neoplasm. We also intended to find prognostic factors in secondary acute myeloid leukemia overall.
  
  
  METHODS
  Retrospective medical record review at Seoul National University Hospital was performed. We assessed response to induction chemotherapy and overall survival.
  
  
  RESULTS
  Ninety-five secondary acute myeloid leukemia patients (median age of 56.4 years) were analyzed. Twenty-six, 57 and 12 patients had therapy-related leukemia, leukemia following myelodysplastic syndrome and myeloproliferative neoplasm, respectively. For patients receiving induction chemotherapy, complete remission rate was 47.5% and complete remission rate was different according to the type of the preceding disorders (P = 0.004). Compared to therapy-related leukemia (P = 0.027) and leukemia following myelodysplastic syndrome (P = 0.050), leukemia following myeloproliferative neoplasm had shorter overall survival. In secondary leukemia, 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.
  
  
  CONCLUSIONS
  Prognosis of secondary acute myeloid leukemia was different according to the type of the preceding disorders with the worst prognosis in leukemia following myeloprolfierative neoplasm. Along with cytogenetic risk grouping, trisomy 8 had a poor prognostic impact in secondary acute myeloid leukemia.
authors.affiliation: Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Youngil
authors.initials: Y
authors.lastname: Koh
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Bae
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Song
authors.forename: Hyun-Kyung
authors.initials: HK
authors.lastname: Kim
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Dong Soon
authors.initials: DS
authors.lastname: Lee
authors.forename: Sung Sup
authors.initials: SS
authors.lastname: Park
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Park
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
authors.forename: Byoung Kook
authors.initials: BK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics*; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000209:etiology* / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications*; D009196:Myeloproliferative Disorders / Q000150:complications*; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D014314:Trisomy; D055815:Young Adult
chemical_list: D003561:Cytarabine; D015255:Idarubicin; D003630:Daunorubicin