Adamska Monika, Kowal-Wiśniewska Ewelina, Barańska Marta, Przybyłowicz-Chalecka Anna, Łojko-Dankowska Anna, Joks Monika, Jarmuż-Szymczak Małgorzata, Gil Lidia
Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland.
Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
J Clin Med. 2024 Feb 8;13(4):989. doi: 10.3390/jcm13040989.
: Acute myeloid leukemia post cytotoxic therapy (AML-pCT) among breast cancer (BC) survivors represents a life-threatening complication. This study aims to assess the clinical outcomes of AML-pCT post BC. : An analysis of all AML patients treated at a single hematology center (2000-2023) was performed to select patients with AML-pCT post BC. We applied the 2022 ELN criteria to define the genetic risk. : Among 847 AML patients, 28 were diagnosed with AML-pCT following BC. Complex karyotype (CK) occurred in 23.8% of patients. The median overall survival (OS) was 40 months. The survival outcomes were better after allogenic hematopoietic stem cell transplantation (alloHCT) treatment compared to chemotherapy alone (median OS: 47 versus 7 months, = 0.008). Patients demonstrating CK showed lower survival compared to those without CK (2-year OS: 25.0% versus 66.2%, = 0.0048). The multivariable Cox proportional hazards regression model indicated that treatment with alloHCT emerged as a significant factor associated with improved OS. The treatment was associated with superior OS (HR = 0.07, 95% CI = 0.01-0.86, = 0.04). : Patients with AML-pCT following BC were characterized with the highest frequency of adverse genetic risk profiles and demonstrated worse survival rates. AlloHCT should be performed as early as possible in such patients. The growing need for studies on inherited cancer susceptibility underscores the importance of close AML-pCT development monitoring in BC survivors.
乳腺癌（BC）幸存者中细胞毒性治疗后急性髓系白血病（AML-pCT）是一种危及生命的并发症。本研究旨在评估BC后AML-pCT的临床结局。：对在单一血液学中心接受治疗的所有AML患者（2000 - 2023年）进行分析，以选择BC后发生AML-pCT的患者。我们应用2022年欧洲白血病网络（ELN）标准来定义遗传风险。：在847例AML患者中，28例在BC后被诊断为AML-pCT。23.8%的患者出现复杂核型（CK）。中位总生存期（OS）为40个月。与单纯化疗相比，异基因造血干细胞移植（alloHCT）治疗后的生存结局更好（中位OS：47个月对7个月，P = 0.008）。出现CK的患者与未出现CK的患者相比生存率更低（2年OS：25.0%对66.2%，P = 0.0048）。多变量Cox比例风险回归模型表明，alloHCT治疗是与OS改善相关的一个重要因素。该治疗与更好的OS相关（风险比[HR] = 0.07，95%置信区间[CI] = 0.01 - 0.86，P = 0.04）。：BC后发生AML-pCT的患者具有不良遗传风险特征的频率最高，且生存率较差。对此类患者应尽早进行alloHCT。对遗传性癌症易感性研究的需求不断增加，凸显了密切监测BC幸存者中AML-pCT发生情况的重要性。
