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

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

doi:10.56875/2589-0646.1113

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

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

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

Hematology/oncology and stem cell therapy, Vol.17(1), pp.79-87

07/20/2023

DOI: 10.56875/2589-0646.1113

PMID: 37581464

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Abstract

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

Details

Title: Subtitle: Therapy-related Acute Myeloid Leukemia in Non-Hodgkin Lymphoma Survivors: Risk, Survival Outcomes and Prognostic Factor Analysis
Creators: Utsav Joshi - Rochester General Hospital
Adheesh Bhattarai - Tribhuvan University Teaching Hospital
Suman Gaire - Mount Saint Vincent University
Pravash Budhathoki - The Bronx Defenders
Vishakha Agrawal - Tribhuvan University Teaching Hospital
Roshan Subedi - Unity Hospital
Bishesh S Poudyal - Civil Service Hospital
Prajwal Dhakal - University of Iowa
Ronald Sham - Rochester General Hospital
Vijaya R Bhatt - University of Nebraska Medical Center
Resource Type: Journal article
Publication Details: Hematology/oncology and stem cell therapy, Vol.17(1), pp.79-87
DOI: 10.56875/2589-0646.1113
PMID: 37581464
NLM abbreviation: Hematol Oncol Stem Cell Ther
ISSN: 1658-3876
eISSN: 2589-0646
Language: English
Date published: 07/20/2023
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984455615202771

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