Elderly Patients (Age 70 Years or Older) With Secondary Acute Myeloid Leukemia or Acute Myeloid Leukemia Developed Concurrently to Another Malignant Disease

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 18; no. 5; pp. e211 - e218
• Main Authors: Collinge, Elodie, Loron, Sandrine, Larcher, Marie-Virginie, Elhamri, Mohamed, Heiblig, Maël, Deloire, Alexandre, Ducastelle, Sophie, Labussière, Hélène, Barraco, Fiorenza, Wattel, Eric, Salles, Gilles, Paubelle, Etienne, Thomas, Xavier
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2018
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Cohort Studies; Female; Hematologic Diseases - complications; Humans; Hypomethylating agents; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Male; Neoplasms - complications; Neoplasms, Second Primary - complications; Neoplasms, Second Primary - etiology; Neoplasms, Second Primary - mortality; Neoplasms, Second Primary - therapy; Prognosis; Remission Induction; Survival Analysis; Treatment; Treatment-related leukemia; Chemotherapy; Treatment-related leukemia; Prognosis; Treatment; Hypomethylating agents
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/j.clml.2018.02.018

This study gives a detailed description of acute myeloid leukemia (AML) following another malignancy in a single-center cohort of patients with AML aged 70 and older. The most important finding is the lack of independent prognostic impact of secondary AML in elderly patients. Secondary acute myeloid leukemia (sAML) remains a therapeutic challenge. In elderly patients with AML, it is unclear whether sAML displays an inferior outcome compared with de novo AML. We studied AML with an antecedent of hematologic disease, treatment-related AML, or AML occurring concurrently to another malignancy in a single-center cohort of patients aged 70 and older with AML. The study included 169 patients who were compared with a cohort of patients with de novo AML, without any prior history of malignant disorders, seen during the same period of time. Hematologic antecedents or presence of prior/concurrent solid malignancy did not impact complete remission rates and overall survival. In multivariate analysis, sAML appeared without independent prognostic value in the elderly. Our results support that sAML and de novo AML in elderly patients are not prognostically distinct entities. They should therefore not be considered separately when investigating outcomes and new treatment strategies.