Secondary AML includes subtypes t-AML and AML-MRC1-3
Therapy-related AML (t-AML): ~4% to 10% of all AML cases1,2
The 2016 WHO classification defines t-AML as AML that arises from treatment with cytotoxic therapy or ionizing radiotherapy for an unrelated disease or prior cancer4,5
Prior malignancies associated with t-AML6,a
- Distribution of previous disease in 203 patients with t-AML regardless of treatment intent. Data from a national, population-based study of 3055 patients diagnosed with AML from 2000 to 2013 in Denmark.6
Granfeldt Østgård LS, et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a national population-based cohort study. J Clin Oncol. 2015;33(31):3641-3649. Reprinted with permission. © 2015 American Society of Clinical Oncology. All rights reserved.
AML with myelodysplasia-related changes (AML-MRC): ~24% to 35% of all AML cases3,b
The 2016 WHO classification defines AML-MRC as ≥20% blasts in the peripheral blood or bone marrow and ANY of the following5,7:
- Incidence is variable based on the definition of AML-MRC used.3
- Complex karyotype: 3 or more abnormalities.5
- Unbalanced abnormalities: -7/del(7q), del(5q)/t(5q), i(17q)/t(17p), -13/del(13q), del(11q), del(12p)/t(12p), idic(X)(q13).5
- Balanced abnormalities: t(11;16)(q23.3;p13.3), t(3:21)(q26.2;q22.1), t(1;3)(p36.3;q21.2), t(2;11)(p21;q23.3), t(5;12)(q32;p13.2), t(5;7)(q32;q11.2), t(5;17)(q32;p13.2), t(5;10)(q32;q21.2), t(3;5)(q25.3;q35.1).5
A majority of AML-MRC cases DO NOT present with a documented history of MDS or MDS/MPN8,f
PATIENTS WITH AML-MRC WHO PRESENTED WITHOUT ANTECEDENT HEMATOLOGICAL DISORDER8
As AML-MRC often occurs as de novo AML with MDS-related cytogenetic changes or multilineage dysplasia, AML-MRC patients may go unidentified without comprehensive testing8,9
As AML-MRC often occurs as de novo AML with MDS-related cytogenetic changes or multilineage dysplasia, AML-MRC patients may go unidentified without comprehensive testing8,9
PATIENTS WITH AML-MRC WHO PRESENTED WITH ANTECEDENT HEMATOLOGICAL DISORDER8
- Study of 175 adult patients with AML-MRC classified by 2008 WHO criteria.8
Among the most common genetic abnormalities found in the unfavorable cytogenetic risk group in AML are -7/del(7q) and -5/del(5q)12,13
Proper identification of AML-MRC is important in determining the appropriate treatment plan.6 Two studies have shown outcomes in clinically stabilized older patients are not negatively impacted by longer time from diagnosis to treatment to allow for genetic and laboratory testing10,11,g
- Two studies looked at the effect of time from diagnosis to treatment start on patient prognosis: results from a retrospective study in patients with de novo AML or sAML 60 years of age or older (n=664)11 and an analysis of real-world SAL-AML registry data of patients with newly-diagnosed AML, including sAML (n=2263).10