title: Effect of therapy-related acute myeloid leukemia on the outcome of patients with acute myeloid leukemia.
abstract: Therapy-related acute myeloid leukemia (t-AML) is a rare and almost always fatal late side effect of antineoplastic treatment involving chemotherapy, radiotherapy or the two combined. The present retrospective study intended to characterize t-AML patients that were diagnosed and treated in a single referral to an oncological institution in North Portugal. Over the past 10 years, 231 cases of AML were diagnosed and treated at the Portuguese Institute of Oncology of Porto, of which 38 t-AML cases were identified. Data regarding the patient demographics, primary diagnosis and treatment, age at onset of therapy-related myeloid neoplasm, latency time of the neoplasm, cytogenetic characteristics, AML therapy and outcome were collected from medical records. A previous diagnosis with solid tumors was present in 28 patients, and 10 patients possessed a history of hematological conditions, all a lymphoproliferative disorder. Breast cancer was the most frequent solid tumor identified (39.5% of all solid tumors diagnosed). The mean latency time was 3 years. In the present study, t-AML patients were older (P<0.001) and more frequently carried cytogenetic abnormalities (P=0.009) compared withde novoAML patients. The overall survival time was observed to be significantly poorer among individuals with t-AML (P<0.001). However, in younger patients (age, <50 years) there was no difference between the overall survival time of patients with t-AML and those withde novoAML (P=0.983). Additionally, patients with promyelocytic leukemia possess a good prognosis, even when AML occurs as a secondary event (P=0.98). To the best of our knowledge, the present study is the first to evaluate t-AML in Portugal and the results are consistent with the data published previously in other populations. The present study concludes that although t-AML demonstrates a poor prognosis, this is not observed among younger patients or promyelocytic leukemia patients.
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Ana Espírito
authors.initials: AE
authors.lastname: ESPíRITO Santo
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Chacim
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ferreira
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Leite
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Claudia
authors.initials: C
authors.lastname: Moreira
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Dulcineia
authors.initials: D
authors.lastname: Pereira
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Margarida Dantas
authors.initials: MD
authors.lastname: Dantas Brito
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Nunes
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Nelson
authors.initials: N
authors.lastname: Domingues
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Oliveira
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Ilídia
authors.initials: I
authors.lastname: Moreira
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Angelo
authors.initials: A
authors.lastname: Martins
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Viterbo
authors.affiliation: Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: José Mário
authors.initials: JM
authors.lastname: Mariz
authors.affiliation: Molecular Oncology and Viral Pathology Group Investigation Centre, Portuguese Institute of Oncology of Porto, Porto, Portugal; Abel Salazar Institute of Biomedical Sciences, University of Porot, Porto, Portugal; Department of Oncology, Portuguese Institute of Oncology, Porto, Portugal; Biomedical Research Centre, Faculty of Health Sciences of Fernando Pessoa University, Porto, Portugal; Department of Research, Portuguese League Against Cancer (Regional North Core), Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Medeiros
keywords: acute myeloid leukemia; age; cytogenetics; therapy-related acute myeloid leukemia