Secondary Acute Myeloid Leukemia: Pathogenesis and Treatment | Exon Publications

Leukemia open access book cover

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Published: Oct 16, 2022

DOI: https://doi.org/10.36255/exon-publications-leukemia-secondary-acute-myeloid-leukemia

Keywords:

acute myeloid leukemia, secondary acute myeloid leukemia, acute myeloid leukemia with myelodysplastic-related changes, therapy-related acute myeloid leukemia

Debora Capelli, MD

Hematology department, University of Ancona, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy

Diego Menotti, MD

Hematology department, University of Ancona, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy

Alessandro Fiorentini, MD

Hematology department, University of Ancona, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy

Francesco Saraceni, MD

Hematology department, University of Ancona, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy

Attilio Olivieri, MD

Hematology department, University of Ancona, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy

ABSTRACT

Secondary acute myeloid leukemia includes acute myeloid leukemia that arises either from a previous myeloid hematologic disease such as myelodysplastic syndrome, chronic myeloproliferative syndrome, or myelodysplastic/myeloproliferative overlap syndromes or from a previous chemotherapy or radiotherapy performed for another disease. Secondary acute myeloid leukemia is characterized by a worse prognosis than its de novo counterparts, with a 5-year overall survival of <30% despite an advanced insight into pathogenesis and new available treatments. The best therapeutic strategy is to achieve complete remission with a negative minimal residual disease followed by hematopoietic stem cell transplantation; however, advanced age of patients at diagnosis, multiple comorbidities, and lower rate of complete remission makes these approaches available only for a small fraction of secondary acute myeloid leukemia patients. In this chapter, we discuss the epidemiology, pathogenesis, and prognostic factors of secondary acute myeloid leukemia. Also, we discuss the main treatments currently available for eligible patients (fit patients) and non-eligible patients (unfit patients) for intensive chemotherapy and future treatment perspectives.

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