E-ISSN: 1308-5263
Clinical Characteristics and Optimal Therapy of Acute Myeloid Leukemia with Myelodysplasia-related-changes: A Retrospective Analysis in a Cohort of Chinese Patients [Turk J Hematol]
Turk J Hematol. Ahead of Print: TJH-34033 | DOI: 10.4274/tjh.galenos.2021.2021.0009  

Clinical Characteristics and Optimal Therapy of Acute Myeloid Leukemia with Myelodysplasia-related-changes: A Retrospective Analysis in a Cohort of Chinese Patients

Lei Wang1, Xiaoxia Chu1, Jingyao Wang1, Licai An1, Yinghui Liu1, Li Li2, Junqing Xu1
1Qingdao University Medical College, Affiliated Yantai Yuhuangding Hospital, Department of Hematology, Yantai, China
2Linyi Central Hospital, Department of Hematology, Linyi, China

Objective: This study aimed to investigate the clinical characteristics of acute myeloid leukemia with myelodysplasia-related-changes (AML-MRC) according to the 2016 WHO classification and the preferred therapy of patients with AML-MRC and aged 60-75 years.
Materials and Methods: We retrospectively analyzed the differences of clinical data between 190 patients with AML-MRC and 667 patients with AML not otherwise specified (AML-NOS). And we compared different therapeutic regimens among patients with AML-MRC and aged 60-75 years.
Results: Compared with AML-NOS, patients with AML-MRC had significantly different clinical characteristics as well as worse overall survival (OS) (9.2 vs 13.6 months; p<0.001) and complete remission (CR) rate (65.3% vs 76.2%; p=0.005). Multivariate analysis performed in the whole group (patients with AML-MRC and AML-NOS) showed that AML-MRC was the independent prognostic factor (p=0.002). Additional multivariate analysis performed in 190 patients with AMLMRC indicated that age (p<0.001) and LDH (p=0.031) were independent prognostic factors. Compared with IA/DA regimen [idarubin and cytarabine (IA) or daunorubicin and cytarabine (DA)], DAC+CAG regimen [decitabine and half-dose CAG regimen (cytarabine, aclarubicin and granulocyte colony-stimulating factor)] was associated with better OS (4.5 vs 6.2 months; p=0.021) in patients aged 60-75 years and categorized into unfavorable-risk group.
Conclusion: AML-MRC exhibited worse clinical outcome compared with AMLNOS. Compared with IA/DA regimen, DAC+CAG regimen was the optimal choice for patients with AML-MRC in unfavorable-risk group and aged 60-75 years.

Keywords: Acute Myeloid Leukemia with Myelodysplasia-related-changes, Clinical Characteristics, Therapy




Corresponding Author: Junqing Xu, China


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