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Secondary AML Risk Factors After Stem Cell Transplantation

By: Kayci Reyer
Posted: Monday, August 10, 2020

According to research performed by Mohamad Mohty, MD, PhD, of the Université Pierre et Marie Curie in France, and colleagues, and published in Blood Cancer Journal, secondary acute myeloid leukemia (AML) may be an independent risk factor for outcomes in patients who have undergone allogeneic stem cell transplantation (alloSCT) and who have entered complete remission. Patients who developed secondary AML after receiving chemotherapy, radiation, or after hematologic disease typically have an inferior prognosis when compared with patients who have de novo AML.

The retrospective study included 11,439 patients with de novo disease and 1,325 patients with secondary disease, all of whom had undergone alloSCT between January 2000 and December 2016. A total of 8,600 participants had achieved first complete remission. Among those in first complete remission, the 3-year and general cumulative incidence of relapse and nonrelapse mortality rates were higher for patients with secondary disease (35.0% vs. 28.5%; hazard ratio [HR] = 1.37; P < 10-4 and 23.4% vs. 16.4%; HR = 1.27; P < 10-3, respectively).

Secondary disease was associated with inferior rates of 3-year and general overall survival (46.7% vs. 60.8%; HR = 1.33; P  <  10-5), leukemia-free survival (41.6% vs. 55.1%; HR = 1.32; P  <  10-5), and graft-versus-host disease/relapse-free survival (28.4% vs. 38.6%; HR = 1.2; P <  10-5).

“These data help to improve risk stratification and prognostic estimates after allogeneic stem cell transplantation for secondary acute myeloid leukemia,” concluded the investigators.

Disclosure: The study authors have reported no conflicts of interest.


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