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

Authors

Utsav Joshi, Rochester Regional HealthFollow
Adheesh Bhattarai, Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Suman Gaire, Department of Internal Medicine, Mount Sinai Chicago, Chicago, IL, USA.
Pravash Budhathoki, Department of Internal Medicine, Bronx Care Health System, NY, USA.
Vishakha Agrawal, Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Roshan Subedi, Rochester Regional HealthFollow
Bishesh S. Poudyal, Clinical Hematology and Bone Marrow Transplant Unit, Civil Service Hospital, Kathmandu, Nepal.
Prajwal Dhakal, Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA, USA.
Ronald Sham, Rochester Regional HealthFollow
Vijaya R. Bhatt, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Hematology/Oncology and Stem Cell Therapy

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.

First Page

79

Last Page

87

DOI

10.56875/2589-0646.1113

Volume

17

Issue

1

Publication Date

7-20-2023

Medical Subject Headings

Humans; Middle Aged; Prognosis; Neoplasms, Second Primary (etiology, complications); Leukemia, Myeloid, Acute (epidemiology); Lymphoma, Non-Hodgkin (drug therapy); Survivors

PubMed ID

37581464

Recommended Citation

Joshi, U., Bhattarai, A., Gaire, S., Budhathoki, P., Agrawal, V., Subedi, R., Poudyal, B. S., Dhakal, P., Sham, R., & Bhatt, V. R. (2023). Therapy-related Acute Myeloid Leukemia in Non-Hodgkin Lymphoma Survivors: Risk, Survival Outcomes and Prognostic Factor Analysis. Hematology/Oncology and Stem Cell Therapy, 17 (1), 79-87. https://doi.org/10.56875/2589-0646.1113