title: Secondary acute lymphoblastic leukemia is an independent predictor of poor prognosis.
abstract: Compared to secondary acute myeloid leukemia, secondary acute lymphoblastic leukemia (sALL) is poorly characterized. We utilized data from the Surveillance, Epidemiology, and End Results (SEER) 13 database to further elucidate patient characteristics and prognostic factors in sALL. Cases of adult de novo acute lymphoblastic leukemia (ALL) and sALL in patients with primary breast, rectum, cervix, or ovarian cancers or lymphoma with a latency period of at least 12 months were identified within the SEER 13 database. Survival in sALL and de novo ALL were compared after propensity matching based on age, gender, race, ALL subtype, and year of diagnosis. 4124 cases of de novo ALL and 79 cases of sALL were identified. sALL patients were older at diagnosis (median 62 years vs. 44 years; p<0.01). Overall survival (OS) in sALL was lower than de novo ALL (median 8 months vs. 11 months), 1 year OS: 35% vs. 47% (p=0.05), 2 year OS: 16% vs. 31% (p<0.01), and 5 year OS: 7% vs. 21% (p<0.01). Multivariate analysis revealed sALL as an independent predictor of worsened survival (adjusted HR 1.54; 95% CI 1.16-2.04, p<0.01) after propensity matching.
authors.affiliation: Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Smith
authors.initials: S
authors.lastname: Giri
authors.affiliation: Department of Hematology/Oncology, The West Cancer Center, Memphis, TN, United States. Electronic address: mchi@westclinic.com.
authors.forename: Michelle
authors.initials: M
authors.lastname: Chi
authors.affiliation: Department of Hematology/Oncology, The West Cancer Center, Memphis, TN, United States.
authors.forename: Benny
authors.initials: B
authors.lastname: Johnson
authors.affiliation: Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: David
authors.initials: D
authors.lastname: McCormick
authors.affiliation: Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Omer
authors.initials: O
authors.lastname: Jamy
authors.affiliation: Division of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE, United States.
authors.forename: Vijaya Raj
authors.initials: VR
authors.lastname: Bhatt
authors.affiliation: Department of Hematology/Oncology, The West Cancer Center, Memphis, TN, United States.
authors.forename: Mike G
authors.initials: MG
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D001943:Breast Neoplasms / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007953:Leukemia, Radiation-Induced / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000401:mortality*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D044469:Racial Groups; D011878:Radiotherapy / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000628:therapy; D018426:SEER Program; D059005:Topoisomerase II Inhibitors / Q000009:adverse effects; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000628:therapy
chemical_list: D018906:Antineoplastic Agents, Alkylating; D059005:Topoisomerase II Inhibitors
keywords: Prognosis; Secondary leukemia; Survival