Outcome of Patients With Therapy-Related Acute Myeloid Leukemia With or Without a History of Myelodysplasia.
To learn whether an antecedent hematologic disorder (AHD) is associated with additional risk in patients with therapy-related acute myeloid leukemia (t-AML).



We reviewed data of 301 patients with newly diagnosed t-AML who sought care from January 2000 to January 2014 (183 t-AML without AHD, 118 t-AML with AHD). Overall, median follow-up was 44 months.



The primary malignancy was non-Hodgkin lymphoma in 92 (31%), breast cancer in 80 (27%), and prostate cancer in 49 (16%). Median relapse-free survival (RFS) in t-AML without or with AHD was 10 months and 29 months, respectively (P = .032); median overall survival (OS) was 8 months and 8 months, respectively (P = .53). Multivariate analysis for OS identified older age, poor performance status, thrombocytopenia, nonfavorable cytogenetics, and lack of response as adverse factors.



The favorable-risk cohort had better RFS and OS compared to the outcomes of patients in the intermediate- and adverse-risk cohorts; the RFS and OS did not differ between intermediate- and adverse-risk cohorts. The presence of AHD did not affect OS.
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Koji
K
Sasaki
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Elias
E
Jabbour
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Jorge
J
Cortes
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Tapan
T
Kadia
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Guillermo
G
Garcia-Manero
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Gautam
G
Borthakur
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Preetesh
P
Jain
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Sherry
S
Pierce
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Naval
N
Daver
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Koichi
K
Takahashi
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Susan
S
O'Brien
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Hagop
H
Kantarjian
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: fravandi@mdanderson.org.
Farhad
F
Ravandi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000473:pathology*; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000401:mortality*; D063868:Patient Outcome Assessment; D012306:Risk; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
Acute myeloid leukemia; Antecedent myelodysplastic syndrome; Overall survival; Relapse-free survival; Therapy-related