Secondary acute myeloid leukemia - a single center experience.

Secondary acute myeloid leukemia (sAML) may arise from the previous clonal disorder of hematopoiesis, usually from myelodysplastic syndrome (MDS) or from chronic myeloproliferative neoplasia (cMPN) or after exposure to a leukemogenic agent (previous chemotherapy or radiotherapy, some immunosuppressive drugs or environmental leukemogenic agents). Secondary origin of AML is associated with unfavorable prognosis and it is not considered to be conventionally curable (with the exception of secondary acute promyelocytic leukemia). The presented study is a retrospective analysis of patients diagnosed and treated at the Department of Hemato-Oncology, University Hospital Olomouc in 1996-2008. Over that period of time, a total 574 patients with AML were diagnosed. Of those, 430 patients were diagnosed as having primary AML; in 86 patients, sAML transformed from myelodysplastic syndrome and 58 patients were followed or treated for various malignancies or were treated with potentially leukemogenic agents because of non-malignant disorders. Patients with secondary AML are older and less commonly treated with curative intention than those with primary AML. According to cytogenetic findings, their prognosis is often worse. Complete hematologic remission is achieved with a low probability, relapse of the disease occurs frequently and overall survival is worse in almost all prognostic subgroups. With the exception of secondary acute promyelocytic leukemia, the prognosis of which does not differ from very good prognosis of the primary forms, secondary AML is not considered a conventionally curable disease.