BACKGROUND: Secondary acute myeloid leukemia (AML) from an antecedent myelodysplastic syndrome (MDS)/myeloproliferative neoplasm is associated with a poor prognosis. The authors evaluated predictive factors in patients with secondary AML treated with anthracycline-based induction therapy. METHODS: This was a retrospective review of secondary AML patients treated with induction therapy. Age, International Prognostic Scoring System, Eastern Cooperative Oncology Group performance status, cytogenetics, duration of MDS/myeloproliferative neoplasm, and prior MDS/myeloproliferative neoplasm treatment were evaluated for their impact on complete response (CR), CR with low platelets, and overall survival (OS). RESULTS: The authors evaluated 61 secondary AML patients who received induction chemotherapy; 59% (36 patients) achieved CR/CR with low platelets (95% confidence interval [CI], 46%-71%), and median OS was 6.5 (95% CI, 3.9-8.1) months. Three factors were associated with lower CR/CR with low platelets and OS: poor risk cytogenetics, prior treatment with hypomethylating agents or lenalidomide, and longer time to transformation to AML. Of those treated with hypomethylating agents or lenalidomide, 32% achieved CR/CR with low platelets versus 78% in the group not treated with a hypomethylating agent or lenalidomide (odds ratio [OR], 0.13; 95% CI, 0.04-0.42). Median OS for those treated with a hypomethylating agent or lenalidomide was 3.7 versus 10.5 months for those not treated with a hypomethylating agent or lenalidomide (P < .0001). The CR/CR with low platelets rate for those with intermediate risk cytogenetics was 70% versus 35% for those with poor risk (OR, 4.33; 95% CI, 1.38-13.6). Those with poor risk cytogenetics had a median OS of 2.8 versus 7.5 months for those with intermediate risk (P = .01). CONCLUSIONS: Prior treatment with hypomethylating agents or lenalidomide, poor risk cytogenetics, and longer time to transformation to AML are independent negative predictive factors for response and OS in patients with secondary AML after induction therapy.
BACKGROUND: Secondary acute myeloid leukemia (AML) from an antecedent myelodysplastic syndrome (MDS)/myeloproliferative neoplasm is associated with a poor prognosis. The authors evaluated predictive factors in patients with secondary AML treated with anthracycline-based induction therapy. METHODS: This was a retrospective review of secondary AMLpatients treated with induction therapy. Age, International Prognostic Scoring System, Eastern Cooperative Oncology Group performance status, cytogenetics, duration of MDS/myeloproliferative neoplasm, and prior MDS/myeloproliferative neoplasm treatment were evaluated for their impact on complete response (CR), CR with low platelets, and overall survival (OS). RESULTS: The authors evaluated 61 secondary AMLpatients who received induction chemotherapy; 59% (36 patients) achieved CR/CR with low platelets (95% confidence interval [CI], 46%-71%), and median OS was 6.5 (95% CI, 3.9-8.1) months. Three factors were associated with lower CR/CR with low platelets and OS: poor risk cytogenetics, prior treatment with hypomethylating agents or lenalidomide, and longer time to transformation to AML. Of those treated with hypomethylating agents or lenalidomide, 32% achieved CR/CR with low platelets versus 78% in the group not treated with a hypomethylating agent or lenalidomide (odds ratio [OR], 0.13; 95% CI, 0.04-0.42). Median OS for those treated with a hypomethylating agent or lenalidomide was 3.7 versus 10.5 months for those not treated with a hypomethylating agent or lenalidomide (P < .0001). The CR/CR with low platelets rate for those with intermediate risk cytogenetics was 70% versus 35% for those with poor risk (OR, 4.33; 95% CI, 1.38-13.6). Those with poor risk cytogenetics had a median OS of 2.8 versus 7.5 months for those with intermediate risk (P = .01). CONCLUSIONS: Prior treatment with hypomethylating agents or lenalidomide, poor risk cytogenetics, and longer time to transformation to AML are independent negative predictive factors for response and OS in patients with secondary AML after induction therapy.
Authors: B D Cheson; J M Bennett; H Kantarjian; A Pinto; C A Schiffer; S D Nimer; B Löwenberg; M Beran; T M de Witte; R M Stone; M Mittelman; G F Sanz; P W Wijermans; S Gore; P L Greenberg Journal: Blood Date: 2000-12-01 Impact factor: 22.113
Authors: Alan List; Gordon Dewald; John Bennett; Aristotle Giagounidis; Azra Raza; Eric Feldman; Bayard Powell; Peter Greenberg; Deborah Thomas; Richard Stone; Craig Reeder; Kenton Wride; John Patin; Michele Schmidt; Jerome Zeldis; Robert Knight Journal: N Engl J Med Date: 2006-10-05 Impact factor: 91.245
Authors: B Löwenberg; R Zittoun; H Kerkhofs; U Jehn; J Abels; L Debusscher; C Cauchie; M Peetermans; G Solbu; S Suciu Journal: J Clin Oncol Date: 1989-09 Impact factor: 44.544
Authors: Frederick R Appelbaum; Holly Gundacker; David R Head; Marilyn L Slovak; Cheryl L Willman; John E Godwin; Jeanne E Anderson; Stephen H Petersdorf Journal: Blood Date: 2006-02-02 Impact factor: 22.113
Authors: Lewis R Silverman; Erin P Demakos; Bercedis L Peterson; Alice B Kornblith; Jimmie C Holland; Rosalie Odchimar-Reissig; Richard M Stone; Douglas Nelson; Bayard L Powell; Carlos M DeCastro; John Ellerton; Richard A Larson; Charles A Schiffer; James F Holland Journal: J Clin Oncol Date: 2002-05-15 Impact factor: 44.544
Authors: Hagop M Kantarjian; Susan O'Brien; Jianqin Shan; Ahmed Aribi; Guillermo Garcia-Manero; Elias Jabbour; Farhad Ravandi; Jorge Cortes; Jan Davisson; Jean-Pierre Issa Journal: Cancer Date: 2007-01-15 Impact factor: 6.860
Authors: D Grimwade; H Walker; F Oliver; K Wheatley; C Harrison; G Harrison; J Rees; I Hann; R Stevens; A Burnett; A Goldstone Journal: Blood Date: 1998-10-01 Impact factor: 22.113
Authors: J M Rowe; J W Andersen; J J Mazza; J M Bennett; E Paietta; F A Hayes; D Oette; P A Cassileth; E A Stadtmauer; P H Wiernik Journal: Blood Date: 1995-07-15 Impact factor: 22.113
Authors: Matthew J Walter; Dong Shen; Li Ding; Jin Shao; Daniel C Koboldt; Ken Chen; David E Larson; Michael D McLellan; David Dooling; Rachel Abbott; Robert Fulton; Vincent Magrini; Heather Schmidt; Joelle Kalicki-Veizer; Michelle O'Laughlin; Xian Fan; Marcus Grillot; Sarah Witowski; Sharon Heath; John L Frater; William Eades; Michael Tomasson; Peter Westervelt; John F DiPersio; Daniel C Link; Elaine R Mardis; Timothy J Ley; Richard K Wilson; Timothy A Graubert Journal: N Engl J Med Date: 2012-03-14 Impact factor: 91.245
Authors: Jeffrey E Lancet; Jorge E Cortes; Donna E Hogge; Martin S Tallman; Tibor J Kovacsovics; Lloyd E Damon; Rami Komrokji; Scott R Solomon; Jonathan E Kolitz; Maureen Cooper; Andrew M Yeager; Arthur C Louie; Eric J Feldman Journal: Blood Date: 2014-03-31 Impact factor: 22.113
Authors: Rami S Komrokji; Eric Padron; Daohai Yu; William J Fulp; Yuraima Rodriguez; Sara Tinsley; Alan F List; Jeffrey E Lancet Journal: Am J Hematol Date: 2014-05-16 Impact factor: 10.047
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Authors: Prajwal Boddu; Hagop M Kantarjian; Guillermo Garcia-Manero; Farhad Ravandi; Srdan Verstovsek; Elias Jabbour; Gautam Borthakur; Marina Konopleva; Kapil N Bhalla; Naval Daver; Courtney D DiNardo; Christopher B Benton; Koichi Takahashi; Zeev Estrov; Sherry R Pierce; Michael Andreeff; Jorge E Cortes; Tapan M Kadia Journal: Blood Adv Date: 2017-07-19
Authors: Thomas Prébet; Steven D Gore; Sylvain Thépot; Benjamin Esterni; Bruno Quesnel; Odile Beyne Rauzy; François Dreyfus; Claude Gardin; Pierre Fenaux; Norbert Vey Journal: Br J Haematol Date: 2012-03-06 Impact factor: 6.998
Authors: Joseph M Brandwein; Michelle Geddes; Jeannine Kassis; Andrea K Kew; Brian Leber; Thomas Nevill; Mitchell Sabloff; Irwindeep Sandhu; Andre C Schuh; John M Storring; John Ashkenas Journal: Am J Blood Res Date: 2013-05-05