Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry

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Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry. / Hulegardh, Erik; Nilsson, Christer; Lazarevic, Vladimir; Garelius, Hege; Antunovic, Petar; Rangert Derolf, Asa; Mollgard, Lars; Uggla, Bertil; Wennstrom, Lovisa; Wahlin, Anders; Hoglund, Martin; Juliusson, Gunnar; Stockelberg, Dick; Lehmann, Soren.

In: American Journal of Hematology, Vol. 90, No. 3, 2015, p. 208-214.

Research output: Contribution to journalArticle

Harvard

Hulegardh, E, Nilsson, C, Lazarevic, V, Garelius, H, Antunovic, P, Rangert Derolf, A, Mollgard, L, Uggla, B, Wennstrom, L, Wahlin, A, Hoglund, M, Juliusson, G, Stockelberg, D & Lehmann, S 2015, 'Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry', American Journal of Hematology, vol. 90, no. 3, pp. 208-214. https://doi.org/10.1002/ajh.23908

APA

Hulegardh, E., Nilsson, C., Lazarevic, V., Garelius, H., Antunovic, P., Rangert Derolf, A., Mollgard, L., Uggla, B., Wennstrom, L., Wahlin, A., Hoglund, M., Juliusson, G., Stockelberg, D., & Lehmann, S. (2015). Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry. American Journal of Hematology, 90(3), 208-214. https://doi.org/10.1002/ajh.23908

CBE

Hulegardh E, Nilsson C, Lazarevic V, Garelius H, Antunovic P, Rangert Derolf A, Mollgard L, Uggla B, Wennstrom L, Wahlin A, Hoglund M, Juliusson G, Stockelberg D, Lehmann S. 2015. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry. American Journal of Hematology. 90(3):208-214. https://doi.org/10.1002/ajh.23908

MLA

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Hulegardh, Erik ; Nilsson, Christer ; Lazarevic, Vladimir ; Garelius, Hege ; Antunovic, Petar ; Rangert Derolf, Asa ; Mollgard, Lars ; Uggla, Bertil ; Wennstrom, Lovisa ; Wahlin, Anders ; Hoglund, Martin ; Juliusson, Gunnar ; Stockelberg, Dick ; Lehmann, Soren. / Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry. In: American Journal of Hematology. 2015 ; Vol. 90, No. 3. pp. 208-214.

RIS

TY - JOUR

T1 - Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry

AU - Hulegardh, Erik

AU - Nilsson, Christer

AU - Lazarevic, Vladimir

AU - Garelius, Hege

AU - Antunovic, Petar

AU - Rangert Derolf, Asa

AU - Mollgard, Lars

AU - Uggla, Bertil

AU - Wennstrom, Lovisa

AU - Wahlin, Anders

AU - Hoglund, Martin

AU - Juliusson, Gunnar

AU - Stockelberg, Dick

AU - Lehmann, Soren

PY - 2015

Y1 - 2015

N2 - Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients. Am. J. Hematol. 90:208-214, 2015. (c) 2014 Wiley Periodicals, Inc.

AB - Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients. Am. J. Hematol. 90:208-214, 2015. (c) 2014 Wiley Periodicals, Inc.

U2 - 10.1002/ajh.23908

DO - 10.1002/ajh.23908

M3 - Article

C2 - 25421221

VL - 90

SP - 208

EP - 214

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 3

ER -