Clinical Characteristics of Patients With Secondary AML Based on Pretransplant Therapy for AML
| . | Preceding Induction Chemotherapy* . | ||
|---|---|---|---|
| . | No . | Yes . | P . |
| No. of patients | 46 | 20 | |
| Median age, yrs (range) | 41.9 (6-61) | 35.8 (12-53) | .202 |
| Gender | 29 M, 17 F | 10 M, 10 F | .322 |
| Median time from MDS or AML diagnosis to SCT, mo (range) | 9 (1-57) | 11 (4-58) | .304 |
| MDS-related AML, no. | 29 | 8 | .083 |
| MDS classification at diagnosis | |||
| Refractory anemia (RA), no. | 7 | 2 | |
| RA with excess blasts (RAEB), no. | 12 | 2 | |
| RAEB in transformation, no. | 6 | 1 | |
| Chronic myelomonocytic leukemia, no. | 0 | 1 | |
| Not known† | 4 | 2 | |
| Median time from MDS diagnosis to SCT, mo. (range) | 11 (2-57) | 15 (10-58) | .057 |
| Median time from MDS diagnosis to AML, mo. (range) | 9 (2-54) | 6 (2-33) | .327 |
| Median time from AML diagnosis to SCT, mo. (range) | 1 (<1-8) | 7.5 (5-55) | .0001 |
| Therapy-related AML, no. | 17 | 12 | .083 |
| Etiology of therapy-related AML | |||
| Hodgkin's disease | 12 | 3 | |
| Non-Hodgkin's lymphoma | 2 | 1 | |
| Breast cancer | 0 | 2 | |
| Acute lymphocytic leukemia | 1 | 1 | |
| Ovarian cancer | 0 | 2 | |
| Vasculitis | 0 | 2 | |
| Autoimmune hemolytic anemia | 1 | 0 | |
| Radiation accident | 1 | 0 | |
| Osteosarcoma | 0 | 1 | |
| Diagnosis of MDS before AML, no. | 13 | 3 | .006 |
| Median time from AML diagnosis to SCT | 1 (<1-4) | 5 (3-14) | .0001 |
| PB counts at time of SCT | |||
| Blasts as a % of total white cell count, median (range) | 25 (0-92) | 0 (0-98) | N/A |
| Median absolute blast count, 109 cells/L (range) | 1.85 (0-59.66) | 0 (0-79.09) | N/A |
| Median neutrophil count, 109 cells/L (range) | 0.66 (0-16.84) | 2.74 (0-8.19) | .354 |
| Median platelet count, 109 cells/L (range) | 37 (5-960) | 124 (10-438) | .012 |
| Median hematocrit, % (range) | 28 (16-37) | 34 (25-43) | .0002 |
| Phase of pretransplant treatment at time of SCT | |||
| No induction chemotherapy for secondary AML | 46 | N/A | N/A |
| First complete remission | N/A | 6 | N/A |
| Second complete remission | N/A | 3 | N/A |
| First untreated relapse | N/A | 11 | N/A |
| Cytogenetics before or at time of SCT | |||
| Not done/inadequate | 6 | 7 | .039 |
| Normal | 10 | 2 | .256 |
| Single abnormality | 14‡ | 6ρ | .972 |
| Two or more abnormalities | 161-155 | 51-154 | .433 |
| Patient cytomegalovirus serology, no. | |||
| Positive/negative | 25/19 (2 missing) | 13/6 (1 missing) | .316 |
| . | Preceding Induction Chemotherapy* . | ||
|---|---|---|---|
| . | No . | Yes . | P . |
| No. of patients | 46 | 20 | |
| Median age, yrs (range) | 41.9 (6-61) | 35.8 (12-53) | .202 |
| Gender | 29 M, 17 F | 10 M, 10 F | .322 |
| Median time from MDS or AML diagnosis to SCT, mo (range) | 9 (1-57) | 11 (4-58) | .304 |
| MDS-related AML, no. | 29 | 8 | .083 |
| MDS classification at diagnosis | |||
| Refractory anemia (RA), no. | 7 | 2 | |
| RA with excess blasts (RAEB), no. | 12 | 2 | |
| RAEB in transformation, no. | 6 | 1 | |
| Chronic myelomonocytic leukemia, no. | 0 | 1 | |
| Not known† | 4 | 2 | |
| Median time from MDS diagnosis to SCT, mo. (range) | 11 (2-57) | 15 (10-58) | .057 |
| Median time from MDS diagnosis to AML, mo. (range) | 9 (2-54) | 6 (2-33) | .327 |
| Median time from AML diagnosis to SCT, mo. (range) | 1 (<1-8) | 7.5 (5-55) | .0001 |
| Therapy-related AML, no. | 17 | 12 | .083 |
| Etiology of therapy-related AML | |||
| Hodgkin's disease | 12 | 3 | |
| Non-Hodgkin's lymphoma | 2 | 1 | |
| Breast cancer | 0 | 2 | |
| Acute lymphocytic leukemia | 1 | 1 | |
| Ovarian cancer | 0 | 2 | |
| Vasculitis | 0 | 2 | |
| Autoimmune hemolytic anemia | 1 | 0 | |
| Radiation accident | 1 | 0 | |
| Osteosarcoma | 0 | 1 | |
| Diagnosis of MDS before AML, no. | 13 | 3 | .006 |
| Median time from AML diagnosis to SCT | 1 (<1-4) | 5 (3-14) | .0001 |
| PB counts at time of SCT | |||
| Blasts as a % of total white cell count, median (range) | 25 (0-92) | 0 (0-98) | N/A |
| Median absolute blast count, 109 cells/L (range) | 1.85 (0-59.66) | 0 (0-79.09) | N/A |
| Median neutrophil count, 109 cells/L (range) | 0.66 (0-16.84) | 2.74 (0-8.19) | .354 |
| Median platelet count, 109 cells/L (range) | 37 (5-960) | 124 (10-438) | .012 |
| Median hematocrit, % (range) | 28 (16-37) | 34 (25-43) | .0002 |
| Phase of pretransplant treatment at time of SCT | |||
| No induction chemotherapy for secondary AML | 46 | N/A | N/A |
| First complete remission | N/A | 6 | N/A |
| Second complete remission | N/A | 3 | N/A |
| First untreated relapse | N/A | 11 | N/A |
| Cytogenetics before or at time of SCT | |||
| Not done/inadequate | 6 | 7 | .039 |
| Normal | 10 | 2 | .256 |
| Single abnormality | 14‡ | 6ρ | .972 |
| Two or more abnormalities | 161-155 | 51-154 | .433 |
| Patient cytomegalovirus serology, no. | |||
| Positive/negative | 25/19 (2 missing) | 13/6 (1 missing) | .316 |
Abbreviations: SCT, stem cell transplantation; N/A, not applicable.
Induction chemotherapy use as treatment for secondary AML before transplantation.
In 6 cases classification at diagnosis was not known because records regarding blast count were insufficient to distinguish between RA, RAEB, and RAEB in transformation.
5 cases of −7, 3 cases of −5/del5q−, 1 case of +8, 1 case involved chromosome 11q23, 4 cases involved other chromosome abnormalities.
ρ 3 cases involved chromosome 11q23; 2 cases of −7; and 1 case of +8.
6 cases included −7/del7q−, 5 cases included −5/del5q−, 4 cases included +8, 4 cases included other abnormalities only.
2 cases included −5/del5q; 3 cases included other abnormalities.