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Titel:

The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML.

Dokumenttyp:
Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; nicht gelistet
Autor(en):
Kayser, S; Döhner, K; Krauter, J; Köhne, CH; Horst, HA; Held, G; von Lilienfeld-Toal, M; Wilhelm, S; Kündgen, A; Götze, K; Rummel, M; Nachbaur, D; Schlegelberger, B; Göhring, G; Späth, D; Morlok, C; Zucknick, M; Ganser, A; Döhner, H; Schlenk, RF
Abstract:
To study the characteristics and clinical impact of therapy-related acute myeloid leukemia (t-AML). 200 patients (7.0%) had t-AML and 2653 de novo AML (93%). Patients with t-AML were older (P < .0001) and they had lower white blood counts (P = .003) compared with de novo AML patients; t-AML patients had abnormal cytogenetics more frequently, with overrepresentation of 11q23 translocations as well as adverse cytogenetics, including complex and monosomal karyotypes, and with underrepresentation of intermediate-risk karyotypes (P < .0001); t-AML patients had NPM1 mutations (P < .0001) and FLT3 internal tandem duplications (P = .0005) less frequently. Younger age at diagnosis of primary malignancy and treatment with intercalating agents as well as topoisomerase II inhibitors were associated with shorter latency periods to the occurrence of t-AML. In multivariable analyses, t-AML was an adverse prognostic factor for death in complete remission but not relapse in younger intensively treated patients (P < .0001 and P = .39, respectively), relapse but not death in complete remission in older, less intensively treated patients (P = .02 and P = .22, respectively) and overall survival in younger intensively treated patients (P = .01). In more intensively treated younger adults, treatment-related toxicity had a major negative impact on outcome, possibly reflecting cumulative toxicity of cancer treatment.
Zeitschriftentitel:
Blood
Jahr:
2011
Band / Volume:
117
Heft / Issue:
7
Seitenangaben Beitrag:
2137-45
Sprache:
eng
Volltext / DOI:
doi:10.1182/blood-2010-08-301713
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/21127174
Print-ISSN:
0006-4971
TUM Einrichtung:
III. Medizinische Klinik und Poliklinik (Hämatologie / Onkologie)
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