Treatment patterns and outcomes in secondary acute myeloid leukemia arising after hypomethylating agents: PETHEMA registry study.

Autor: Lloret-Madrid P; Hospital Universitari i Politècnic La Fe, Valencia, Spain., Boluda B; Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain., Martínez-López J; Hospital Universitario 12 de Octubre, Madrid, Spain., Bergua J; Hospital San Pedro Alcántara, Cáceres, Spain., Rodriguez Arboli E; Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CISC), Universidad de Sevilla, Sevilla, Spain., Labrador J; Hospital Universitario de Burgos, Burgos, Spain., Sossa C; FOSCAL, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia., Gil C; Hospital General Universitario de Alicante, Alicante, Spain., Algarra L; Hospital General Universitario de Albacete, Albacete, Spain., Lavilla-Rubira E; Hospital Universitario Lucus Augusti, Lugo, Spain., Serrano J; Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., de Rueda B; Hospital Universitario Miguel Servet, Zaragoza, Spain., Ibañez F; Hospital General Universitario de Valencia, Valencia, Spain., González González BJ; Hospital Universitario de Canarias, Tenerife, Spain., Amigo ML; Hospital General Universitario Morales Meseguer, Murcia, Spain., García Belmonte D; Hospital Universitario Sanitas La Zarzuela, Madrid, Spain., Rodríguez-Medina C; Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain., Gómez-Roncero MI; Hospital Universitario de Toledo, Toledo, Spain., Colorado M; Hospital Universitario Marqués de Valdecilla, Santander, Spain., López Lorenzo JL; Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Tormo M; Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, Valencia, Spain., Arce Fernández O; Hospital Universitario de Basurto, Vizcaya, Spain., Cano-Ferri I; Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain., Solana-Altabella A; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.; Servicio de Farmacia, Área del Medicamento. Hospital Universitari i Politècnic La Fe, Valencia, Spain., Foncillas MA; Hospital Universitario Infanta Leonor, Madrid, Spain., Alfonso Pierola A; Clínica Universidad de Navarra, Pamplona, Spain., Vives S; ICO-Hospital Germans Trias i Pujol, Badalona, José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain., Núñez MV; Hospital Arnau de Vilanova, Valencia, Spain., López-Vidal H; Clínica Dávila, Santiago, Chile., Pérez-Santaolalla E; Hospital Universitario Donostia, Guipúzcoa, Spain., Hermosín Ramos L; Hospital Universitario de Jerez de la Frontera, Cádiz, Spain., García Boyero R; Hospital General Universitari de Castelló, Castellón, Spain., Llorente González L; Hospital de Madrid Norte Sanchinarro, Madrid, Spain., Roldán A; Hospital Infanta Sofia, Madrid, Spain., Calderón SC; Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain., Infante JB; Hospital de Santa Maria, Lisboa, Portugal., Olave T; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., García-Suárez J; Hospital Universitario Príncipe de Asturias, Madrid, Spain., de Laiglesia A; Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Rodríguez-Veiga R; Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain., Trigo F; Hospital Sao Joao, Porto, Portugal., Martínez-Cuadrón D; Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain., Montesinos P; Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2025 Jan 01; Vol. 131 (1), pp. e35696.
DOI: 10.1002/cncr.35696
Abstrakt: Background: Patients with secondary acute myeloid leukemia who previously received hypomethylating agents for prior myeloid neoplasms (HMA-sAML) face a dismal prognosis.
Methods: The authors analyze the characteristics, therapeutic approaches, and outcomes of patients with HMA-sAML from the Programa Español para el Tratamiento de Hemopatías Malignas (PETHEMA) registry.
Results: A total of 479 patients were included, mostly from prior myelodysplastic syndrome (84%). Frontline therapy consisted of intensive chemotherapy (IC) in 31%, low-dose cytarabine-based in 19%, supportive care and clinical trial 17% each, and HMA-based therapy in 12% and 4% in venetoclax-based regimen. Complete remission was achieved in 95 patients (27%), with higher rate among IC and venetoclax-based groups (44% and 41%, respectively). The median overall survival (OS) was 4.93 months, with 7.68 months for IC patients, 7.82 months after HMA monotherapy, and 4.66 months after venetoclax-based regimens. Patients who underwent allogeneic hematopoietic stem cell transplantation in first remission (n = 33, 9%) had a better survival outcome (median OS not reached). Multivariate analyses identified age (≥65 years), Eastern Cooperative Oncology Group >2, higher white blood cell count, and adverse risk cytogenetic as adverse prognostic factors, whereas NPM1 mutation was a favorable factor.
Conclusions: Patients with HMA-sAML have a poor prognosis and suboptimal outcomes with conventional treatments, including BCL2 inhibitors, highlighting the need for clinical trials targeting this population.
(© 2025 American Cancer Society.)
Databáze: MEDLINE
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