Therapy-related Acute Myeloid Leukemia in Non-Hodgkin Lymphoma Survivors: Risk, Survival Outcomes and Prognostic Factor Analysis.

Q1 Medicine

Hematology/ Oncology and Stem Cell Therapy Pub Date : 2023-07-20 DOI:10.56875/2589-0646.1113

Utsav Joshi, Adheesh Bhattarai, Suman Gaire, Pravash Budhathoki, Vishakha Agrawal, Roshan Subedi, Bishesh S Poudyal, Prajwal Dhakal, Ronald Sham, Vijaya R Bhatt

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引用次数: 0

Abstract

Background: Therapy-related acute myeloid leukemia (tAML) is a serious complication in patients with Non-Hodgkin lymphoma (NHL) exposed to chemotherapy or radiation. This extensive database study aims to quantify the risk of tAML in NHL and determine the impact of tAML on the overall survival (OS) of patients with NHL.

Materials and methods: Patients diagnosed with NHL and de novo AML from 2009 to 2018 were identified from the Surveillance, Epidemiology, and End Results database. Multiple primary standardized incidence ratio (SIR) sessions of the SEER*Stat software were used to calculate SIR and the absolute excess risk of tAML. Overall survival (OS) was evaluated using Kaplan-Meier curves and compared using log-rank tests. Multivariate analysis was used to study the role of each covariate on OS in patients with tAML.

Results: The SIR of tAML was 4.89 (95% CI 4.41-5.41), with a higher incidence of tAML observed for age <60 years, NHL prior to 2013 and within 5 years of diagnosis, and those who received chemotherapy. NHL patients with tAML had lower OS than those without tAML (5-year OS 59% vs. 13%, p < 0.001). Patients with tAML showed worse OS than de novo AML in univariate analysis (5-year OS 13% vs. 25%, p = 0.001) but not in multivariate analysis (HR 0.93, 95% CI 0.82-1.04, p = 0.21). Age ≥60 years and lack of chemotherapy were associated with poor OS in tAML subcategory.

Conclusion: Age, time since NHL diagnosis, and receipt of chemotherapy directly influence the risk of development of tAML in NHL survivors.

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非霍奇金淋巴瘤幸存者的治疗相关急性髓系白血病:风险、生存结果和预后因素分析。

背景:治疗相关性急性髓系白血病(tAML)是暴露于化疗或放疗的非霍奇金淋巴瘤(NHL)患者的严重并发症。这项广泛的数据库研究旨在量化NHL中tAML的风险，并确定tAML对NHL患者总生存率(OS)的影响。材料和方法:从监测、流行病学和最终结果数据库中确定2009年至2018年诊断为NHL和新发AML的患者。使用SEER*Stat软件的多个主要标准化发病率比(SIR)会话来计算SIR和tAML的绝对超额风险。使用Kaplan-Meier曲线评估总生存期(OS)，并使用log-rank检验进行比较。采用多变量分析研究各协变量对tAML患者OS的影响。结果:tAML的SIR为4.89 (95% CI 4.41 ~ 5.41)，年龄对tAML的发生率有较高的影响。结论:年龄、诊断为NHL的时间、接受化疗直接影响NHL幸存者tAML的发生风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hematology/ Oncology and Stem Cell Therapy Medicine-Hematology

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

27 weeks

期刊介绍： Hematology Oncology and Stem Cell Therapy is an international, peer-reviewed, open access journal that provides a vehicle for publications of high-quality clinical as well as basic science research reports in hematology and oncology. The contents of the journal also emphasize the growing importance of hematopoietic stem cell therapy for treatment of various benign and malignant hematologic disorders and certain solid tumors.The journal prioritizes publication of original research articles but also would give consideration for brief reports, review articles, special communications, and unique case reports. It also offers a special section for clinically relevant images that provide an important educational value.