Japanese population-based study of increasing incidence and changing distribution of primary cancers in therapy-related acute myeloid leukemia

The clinical relevance of therapy-related acute myeloid leukemia (tAML) is increasing as the number of cancer survivors increases. A population-based study in Osaka (Japan) investigated changes in incidence and primary cancers of tAML over 30 years. Of 9841 patients with AML diagnosed between 1990 and 2020, 638 (6.5%) had tAML. The annual tAML incidence increased during the study period, from 0.13 ot 0.36 per 100,000 population. The proportion of tAML cases in overall AML cases almost doubled. The most common primary cancer was hematologic malignancy (23.1%), followed by breast cancer (14.6%), colorectal cancer (11.5%), and gastric cancer (8.7%). The distribution of primary cancers changed between diagnosis periods, with a prominent increase of breast cancer and a decrease of gastric cancer. The authors conclude that these findings suggest an emerging concern regarding the burden of tAML as a post-cancer therapy complication.