Characteristics and outcomes of patients with therapy-related acute myeloid leukemia with normal karyotype

Bachar Samra, Guillaume Richard-Carpentier, Tapan M. Kadia, Farhad Ravandi, Naval Daver, Courtney D. DiNardo, Ghayas C. Issa, Prithviraj Bose, Marina Y. Konopleva, Musa Yilmaz, Maro Ohanian, Gautam Borthakur, Guillermo Garcia-Manero, Sherry Pierce, Jorge E. Cortes, Hagop Kantarjian, Nicholas J. Short

Research output: Contribution to journalArticle

Abstract

Normal karyotype in therapy-related acute myeloid leukemia (t-AML) is rare and the relative contribution of prior exposure to chemotherapy or radiotherapy to outcomes in these patients remains uncertain. We performed a retrospective study of 742 patients with newly diagnosed AML and normal karyotype (t-AML, n = 61, and non-t-AML, n = 681). Patients with t-AML were older but had a similar mutational profile compared to those with non-t-AML. Overall survival (OS) and relapse-free survival (RFS) were significantly worse for patients with t-AML (P < 0.01 and P = 0.02, respectively). Patients with t-AML had a higher cumulative incidence of death in remission (51% versus 16%, P < 0.01), but not higher cumulative incidence of relapse (42% versus 56%, respectively, P = 0.21). Both intensive induction and allogeneic hematopoietic stem cell transplantation in first remission were associated with improved OS and RFS in non-t-AML but not in t-AML. Overall, although disease biology appears similar between t-AML and non-t-AML with normal karyotype as indicated by similar risks of relapse, death in remission is the main driver of inferior outcome in t-AML. Careful therapeutic decisions are required to mitigate potential treatment-related toxicity in this rare subgroup of patients with t-AML and normal karyotype.

Original languageEnglish (US)
Article number47
JournalBlood Cancer Journal
Volume10
Issue number5
DOIs
StatePublished - May 1 2020

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Samra, B., Richard-Carpentier, G., Kadia, T. M., Ravandi, F., Daver, N., DiNardo, C. D., Issa, G. C., Bose, P., Konopleva, M. Y., Yilmaz, M., Ohanian, M., Borthakur, G., Garcia-Manero, G., Pierce, S., Cortes, J. E., Kantarjian, H., & Short, N. J. (2020). Characteristics and outcomes of patients with therapy-related acute myeloid leukemia with normal karyotype. Blood Cancer Journal, 10(5), [47]. https://doi.org/10.1038/s41408-020-0316-3