Adverse karyotype amplifies risk in secondary acute myeloid leukemia (AML) and AML with myelodysplasia-related changes.

IF 2 4区医学 Q3 HEMATOLOGY

Hematology Pub Date : 2026-12-01 Epub Date: 2026-02-10 DOI:10.1080/16078454.2026.2628479

Toshihiro Matsukawa, Shota Yoshida, Masahiro Onozawa, Fumiaki Fujii, Jun Nagai, Tomoki Takahashi, Shuichi Ota, Junichi Hashiguchi, Akio Mori, Takuto Miyagishima, Makoto Ibata, Yasutaka Kakinoki, Tatsuo Oyake, Satoshi Yamamoto, Toshiaki Hayashi, Kentaro Wakasa, Tomoyuki Saga, Tetsuya Igarashi, Satoshi Iyama, Yutaka Tsutsumi, Katsuya Fujimoto, Masaaki Adachi, Masahiro Yoshida, Daigo Hashimoto, Takanori Teshima

{"title":"Adverse karyotype amplifies risk in secondary acute myeloid leukemia (AML) and AML with myelodysplasia-related changes.","authors":"Toshihiro Matsukawa, Shota Yoshida, Masahiro Onozawa, Fumiaki Fujii, Jun Nagai, Tomoki Takahashi, Shuichi Ota, Junichi Hashiguchi, Akio Mori, Takuto Miyagishima, Makoto Ibata, Yasutaka Kakinoki, Tatsuo Oyake, Satoshi Yamamoto, Toshiaki Hayashi, Kentaro Wakasa, Tomoyuki Saga, Tetsuya Igarashi, Satoshi Iyama, Yutaka Tsutsumi, Katsuya Fujimoto, Masaaki Adachi, Masahiro Yoshida, Daigo Hashimoto, Takanori Teshima","doi":"10.1080/16078454.2026.2628479","DOIUrl":null,"url":null,"abstract":"Background: Secondary acute myeloid leukemia (sAML) and AML with myelodysplasia-related changes (AML-MRC) are associated with poor prognosis, but the impact relative to de novo AML remains controversial. We investigated clinical and genetic features in a multicenter Japanese cohort before CPX-351 approval.Methods: We retrospectively analyzed 294 patients with newly diagnosed AML registered in the Hokkaido Leukemia Net between 2022 and 2023. Propensity score matching was used to adjust baseline variables. Genetic profiles were assessed in 160 matched patients.Results: In the matched cohort, sAML/AML-MRC did not show inferior overall survival compared with non-sAML/non-AML-MRC (P = 0.90). Adverse karyotypes were the predominant determinant among sAML/AML-MRC. Among sAML/AML-MRC patients, adverse karyotypes were associated with poorer survival than those without adverse karyotypes (P = 0.0075). In contrast, non-sAML/non-AML-MRC groups did not affect survival regardless of adverse karyotypes (P = 0.51). Among 65 patients with ELN 2017 adverse-risk, those with TP53 mutations had markedly shorter survival than those with TP53 wild-type (P = 0.018).Conclusions: sAML/AML-MRC with an adverse karyotype had a dismal outcome. These findings provide a benchmark for risk stratification in the pre- CPX-351 era.","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2628479"},"PeriodicalIF":2.0000,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16078454.2026.2628479","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Secondary acute myeloid leukemia (sAML) and AML with myelodysplasia-related changes (AML-MRC) are associated with poor prognosis, but the impact relative to de novo AML remains controversial. We investigated clinical and genetic features in a multicenter Japanese cohort before CPX-351 approval.

Methods: We retrospectively analyzed 294 patients with newly diagnosed AML registered in the Hokkaido Leukemia Net between 2022 and 2023. Propensity score matching was used to adjust baseline variables. Genetic profiles were assessed in 160 matched patients.

Results: In the matched cohort, sAML/AML-MRC did not show inferior overall survival compared with non-sAML/non-AML-MRC (P = 0.90). Adverse karyotypes were the predominant determinant among sAML/AML-MRC. Among sAML/AML-MRC patients, adverse karyotypes were associated with poorer survival than those without adverse karyotypes (P = 0.0075). In contrast, non-sAML/non-AML-MRC groups did not affect survival regardless of adverse karyotypes (P = 0.51). Among 65 patients with ELN 2017 adverse-risk, those with TP53 mutations had markedly shorter survival than those with TP53 wild-type (P = 0.018).

Conclusions: sAML/AML-MRC with an adverse karyotype had a dismal outcome. These findings provide a benchmark for risk stratification in the pre- CPX-351 era.

查看原文本刊更多论文

不良核型增加继发性急性髓性白血病（AML）和AML伴骨髓增生异常相关改变的风险。

背景：继发性急性髓性白血病（sAML）和AML伴骨髓增生异常相关改变（AML- mrc）与预后不良相关，但相对于新生AML的影响仍存在争议。在CPX-351获批前，我们研究了一个多中心日本队列的临床和遗传特征。方法：回顾性分析北海道白血病网在2022年至2023年间登记的294例新诊断的AML患者。倾向评分匹配用于调整基线变量。对160名匹配患者的基因谱进行了评估。结果：在匹配的队列中，与非sAML/非AML-MRC相比，sAML/AML-MRC并不表现出较差的总生存率（P = 0.90）。不良核型是sAML/AML-MRC的主要决定因素。在sAML/AML-MRC患者中，不良核型与无不良核型患者的生存率相关（P = 0.0075）。相比之下，无论不良核型如何，非saml /非aml - mrc组均不影响生存（P = 0.51）。在65例ELN 2017不良风险患者中，TP53突变患者的生存期明显短于TP53野生型患者（P = 0.018）。结论：核型不良的sAML/AML-MRC预后不佳。这些发现为CPX-351前时代的风险分层提供了基准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Hematology 医学-血液学

CiteScore

2.60

自引率

5.30%

发文量

140

审稿时长

3 months

期刊介绍： Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.