Abstract
Characteristics and outcomes of patients with lymphoma who developed therapy-related acute myeloid leukemia or myelodysplastic syndrome – a retrospective analysis of the Polish Adult Leukemia Group
- Hematology Department, Medical University of Łódź, Łódź, Poland
- Department Of Biostatistics And Translational Medicine, Medical University of Łódź, Łódź, Poland
- Hematooncology Department, Provincial Multi-Specialized Oncology and Trauma Center, Łódź, Poland
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
- Department of Hematology, Hospital Brzozów, Brzozów, Poland
- Department of Hematology, Holy Cross Cancer Centre, Kielce, Poland
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
Introduction:
Enhancing lymphoma outcomes increases the risk of therapy-related neoplasms such as acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS).
Material and methods:
Our study, conducted at seven Polish hematology centers between 2011 and 2018, explores clinical features, outcomes, and prognostic factors of t-AML and t-MDS arising after initial lymphoid neoplasms.
Results:
The analysis included 57 patients of median age 65 with t-MDS (n = 38) and t-AML (n = 19). The median time to the onset of t-MDS/AML was 58.7 months. The median overall survival (OS) was 16.1 months. The presence of unfavorable cytogenetics and molecular risk factors (HR 2.88, 95% CI: 1.29–6.42, p = 0.009), hemoglobin level (HR 0.79, 95% CI: 0.65–0.95, p = 0.01) and platelets (HR 0.99, 95% CI: 0.99–0.9996, p = 0.03) were independent prognostic factors influencing OS. Therapy-related myelodysplastic syndrome/acute myeloid leukemia after lymphoma treatment is associated with a dismal prognosis mainly due to poor cytogenetic risk.
Conclusions:
Anemia and thrombocytopenia may indicate more severe impairment of bone marrow function, resulting in further inferior treatment outcomes.
Keywords
lymphoma, therapy-related myeloid neoplasm, therapy-related myelodysplastic syndrome, therapy- related acute myeloid leukemia
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