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Secondary Acute Mye...
Secondary Acute Myeloid Leukemia and the Role of Allogeneic Stem Cell Transplantation in a Population-Based Setting
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- Nilsson, Christer (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Sweden
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- Hulegårdh, Erik (author)
- Sahlgrens Univ Hosp, Dept Med, Sect Hematol & Coagulat, Gothenburg, Sweden,Sahlgrenska University Hospital
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- Garelius, Hege (author)
- Sahlgrens Univ Hosp, Dept Med, Sect Hematol & Coagulat, Gothenburg, Sweden,Sahlgrenska University Hospital
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- Möllgård, Lars (author)
- Sahlgrens Univ Hosp, Dept Med, Sect Hematol & Coagulat, Gothenburg, Sweden,Sahlgrenska University Hospital
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- Brune, Mats (author)
- Sahlgrens Univ Hosp, Dept Med, Sect Hematol & Coagulat, Gothenburg, Sweden,Sahlgrenska University Hospital
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- Wahlin, Anders (author)
- Umeå University,Umeå universitet,Onkologi,Univ Umea, Dept Radiat Sci, Umea, Sweden
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- Lenhoff, Stig (author)
- Lund University,Lunds universitet,Avdelningen för hematologi och transfusionsmedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Hematology and Transfusion Medicine,Department of Laboratory Medicine,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden
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- Frödin, Ulla (author)
- Linköpings universitet,Linköping University,Institutionen för medicin och hälsa,Medicinska fakulteten,Region Östergötland, Hematologiska kliniken US
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- Remberger, Mats (author)
- Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden,Karolinska University Hospital
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- Höglund, Martin (author)
- Uppsala University,Uppsala universitet,Hematologi,Uppsala Univ, Sweden
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- Juliusson, Gunnar (author)
- Lund University,Lunds universitet,Stamcellscentrum (SCC),Avdelningen för stamcellsforskning,Institutionen för laboratoriemedicin,Medicinska fakulteten,Stem Cell Center,Division of stem cell research,Department of Laboratory Medicine,Faculty of Medicine,Lund Univ, Sweden
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- Stockelberg, Dick (author)
- Sodra Alvsborgs Hosp, Dept Med & Oncol, Boras, Sweden,South Elfsborg Hospital
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- Lehmann, Sören (author)
- Karolinska Institutet,Uppsala University,Karolinska Institute,Karolinska Inst, Sweden; Uppsala Univ, Sweden
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(creator_code:org_t)
- Elsevier, 2019
- 2019
- English.
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In: Biology of blood and marrow transplantation. - : Elsevier. - 1083-8791 .- 1523-6536. ; 25:9, s. 1770-1778
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Abstract
Subject headings
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- Secondary AML (s-AML), including AML with an antecedent hematologic disorder (AHD-AML) and therapy-related AML (t-AML), constitutes a large proportion of patients with AML and is considered to confer a dismal prognosis. The role of allogeneic hematopoietic cell transplantation (HCT) in patients with s-AML and the extent to which HCT is performed in these patients has been little studied to date. We used the population-based Swedish AML Registry comprising 3337 intensively treated adult patients over a 17-year period to study the role of HCT within the group of patients with s-AML as well as compared with patients with de novo AML. HCT was performed in 576 patients (22%) with de novo AML, in 74 patients (17%) with AHD-AML, and in 57 patients (20%) with t-AML. At 5 years after diagnosis, there were no survivors among patients with previous myeloproliferative neoplasms who did not undergo HCT, and corresponding survival for patients with antecedent myelodysplastic syndromes and t-AML was and 2% and 4%, respectively. HCT was compared with chemotherapy consolidation in s-AML using 3 models: (1) a 200-day landmark analysis, in which HCT was favorable compared with conventional consolidation (P = .04, log-rank test); (2) a multivariable Cox regression with HCT as a time-dependent variable, in which the hazard ratio for mortality was 0.73 (95% confidence interval, 0.64 to 0.83) for HCT and favored HCT in all subgroups; and (3) a propensity score matching analysis, in which the 5-year overall survival (OS) and relapse-free survival in patients with s-AML in first complete remission (CR1) was 48% and 43%, respectively, for patients undergoing HCT versus 20% and 21%, respectively, for those receiving chemotherapy consolidation (P = .01 and .02, respectively, log-rank test). Our observational data suggest that HCT improves survival and offers the only realistic curative treatment option in patients with s-AML.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- Secondary AML
- Therapy-related AML
- Allogeneic hematopoietic cell transplantation
- Population-based
- Allogeneic hematopoietic cell transplantation
- Population-based
- Secondary AML
- Therapy-related AML
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Nilsson, Christe ...
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Hulegårdh, Erik
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Garelius, Hege
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Möllgård, Lars
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Brune, Mats
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Wahlin, Anders
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show more...
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Lenhoff, Stig
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Frödin, Ulla
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Remberger, Mats
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Höglund, Martin
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Juliusson, Gunna ...
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Stockelberg, Dic ...
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Lehmann, Sören
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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Biology of blood ...
- By the university
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Umeå University
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Uppsala University
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Lund University
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Karolinska Institutet
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Linköping University