Mayo Clinic experience with 1123 adults with acute myeloid leukemia

Kebede H. Begna, Walid Ali, Gangat Naseema Gangat, Michelle A. Elliott, Aref Al-Kali, Mark R. Litzow, C. Christopher Hook, Alexandra P. Wolanskyj-Spinner, William J. Hogan, Mrinal M. Patnaik, Animesh Pardanani, Darci L. Zblewski, Dong Chen, Rong He, David Viswanatha, Curtis A. Hanson, Rhett P. Ketterling, Ayalew Tefferi

Research output: Contribution to journalArticlepeer-review

Abstract

Between 2004 and 2017, a total of 1123 adult patients (median age 65 years; 61% males) with newly diagnosed acute myeloid leukemia (AML), not including acute promyelocytic leukemia, were seen at the Mayo Clinic. Treatment included intensive (n = 766) or lower intensity (n = 144) chemotherapy or supportive care (n = 213), with respective median survivals of 22, 9, and 2 months (p < 0.01). Intensive chemotherapy resulted in complete remission (CR) and CR with incomplete count recovery (CRi) rates of 44 and 33%, respectively, with no difference in survival outcome between the two (p = 0.4). Allogeneic hematopoietic stem cell transplant (AHSCT) was documented in 259 patients and provided the best survival rate (median 55 months; p < 0.01). After a median follow-up of 13 months, 841 (75%) deaths were recorded. Multivariate analysis identified age >60 years (HR 2.2, 1.9–2.6), adverse karyotype (HR 2.9, 1.9–4.9), intermediate-risk karyotype (HR 1.6, 1.02–2.6), post-myeloproliferative neoplasm AML (HR 1.9, 1.5–2.4), and other secondary AML (HR 1.3 (1.1–1.6) as risk factors for shortened survival. These risk factors retained their significance after inclusion of FLT3/NPM1 mutational status in 392 informative cases: FLT3+NPM1− (HR 2.8, 1.4–5.6), FLT3+/NPM+ (HR 2.6 (1.3–5.2), and FLT3−NPM1− (HR 1.8, 1.0–3.0).

Original languageEnglish (US)
Article number46
JournalBlood cancer journal
Volume11
Issue number3
DOIs
StatePublished - Mar 2021

ASJC Scopus subject areas

  • Hematology
  • Oncology

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