title: Prior hypomethylating agent use lacks impact on clinical outcome in patients with secondary acute myeloid leukemia arising from myelodysplastic syndromes treated with standard induction chemotherapy.
abstract: Patients with secondary acute myeloid leukemia (sAML) arising from prior myelodysplastic syndromes have poor prognosis. Anthracycline plus cytarabine (7 + 3) is a standard treatment option for patients who are fit for intensive therapy. In the present study, 22 of 96 sAML patients (23 %) were treated with 7 + 3 and achieved median overall survival (OS) of 9.8 months. Hypomethylating agents (HMA) were given for MDS in 6/22 (28 %) of the patients. When evaluating the prior HMA group, CR/CRi was 50 % for those with prior HMA exposure and 63 % for those without HMA exposure (P = 0.6). Median OS was 14 months for prior HMA exposure vs 10 months for no prior HMA (P = 0.9). The outcome of sAML patients who were treated with 7 + 3 continues to be poor. No statistical significant difference was found between response rates and mOS between prior HMA exposure or not. Additional larger studies are needed to confirm our results.
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Salih
authors.initials: S
authors.lastname: Subari
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Firas
authors.initials: F
authors.lastname: Baidoun
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Muhanad
authors.initials: M
authors.lastname: Hreh
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Mrinal
authors.initials: M
authors.lastname: Patnaik
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Shahrukh
authors.initials: S
authors.lastname: Hashmi
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Elliott
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: William
authors.initials: W
authors.lastname: Hogan
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Litzow
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. alkali.aref@mayo.edu.
authors.forename: Aref
authors.initials: A
authors.lastname: Al-Kali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001374:Azacitidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D003561:Cytarabine / Q000627:therapeutic use*; D000077209:Decitabine; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D016609:Neoplasms, Second Primary / Q000188:drug therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D000077209:Decitabine; D001374:Azacitidine
keywords: Acute myeloid leukemia; Hypomethylating agents; Myelodysplasia; Secondary