Outcome of patients with therapy-related acute myeloid leukemia with or without an antecedent history of myelodysplasia

We reviewed 301 patients with newly diagnosed therapy-related acute myeloid leukemia (t-AML) who presented from January 2000 to January 2014 (183, t-AML without antecedent hematologic disorders [AHD]; 118, t-AML with AHD). Overall, median follow-up was 44 months. The primary malignancy was non-Hodgkin lymphoma in 92 (31%); breast cancer in 80 (27%); and prostate cancer in 49 (16%). Median relapse-free survival (RFS) in t-AML without or with AHD was 10 months, and 29 months, respectively (p=0.032): median overall survival (OS) was 8 months, and 8 months, respectively (p=0.53). Multivariate analysis for OS identified older age, poor performance status, thrombocytopenia, non-favorable cytogenetics, and lack of response as adverse factors. The favorable risk cohort had better RFS and OS as compared to the outcomes of patients in the intermediate and adverse risk cohorts; the RFS and OS did not differ between intermediate and adverse cohorts. The presence of AHD did not affect OS. the t-AML with AHD cohort. A higher CR rate was seen in the t-AML without AHD cohort compared to the stem cell transplantation.