SEER analysis of survival difference between secondary and de novo acute myeloid leukemia

A retrospective study using data from the SEER 17 registries investigated survival of patients with secondary AML (sAML) compared with de novo AML (dnAML) by age at AML diagnosis, chemotherapy receipt, and cancer type preceding sAML diagnosis. Overall, individuals with sAML had an 8% higher risk of dying from AML compared to patients with dnAML (HR 1.08; 95% CI 1.05-1.11). Disparities widened with younger age at diagnosis, particularly in those who received chemotherapy (HR 1.14; 95% CI 1.10-1.19). In patients aged 20-64 years who received chemotherapy the HRs versus dnAML were greatest for those with antecedent myelodysplastic syndrome (HR 2.04; 95% CI 1.83-2.28), ovarian cancer (1.91; 1.19-3.08), and head and neck cancer (1.55; 1.02-2.36), while among patients aged 65 years or older who received chemotherapy, the HRs versus dnAML were greatest for those with antecedent cervical cancer (2.42; 1.15-5.10). During the study period, the survival gap between sAML and dnAML widened from 7.2% during 2001-2003 to 14.3% during 2012-2014. The authors conclude that significant and growing survival disparities exist between sAML en dnAML.