Survivorship in AML – a landmark analysis on the outcomes of acute myelogenous leukemia patients after maintaining complete remission for at least 3 years
C. Kendall Major, Hagop M. Kantarjian, Koji Sasaki, Gautam Borthakur, Tapan M. Kadia, Naveen Pemmaraju, Courtney D. DiNardo, Nicholas J. Short, Naval Daver, Elias Jabbour, Richard E. Champlin, Guillermo Garcia‐Manero, Marina Konopleva, Michael Andreeff, Steven M. Kornblau, William G. Wierda, Sherry Pierce, Farhad Ravandi, Jörge E. Cortes
Abstract
Acute myeloid leukemia (AML) carries poor survival and high recurrence rate. We conducted a retrospective analysis of AML patients (N = 453) treated with chemotherapy only or chemotherapy + hematopoietic cell transplant (HCT) who maintained their first complete remission (CR) for ≥3 years. Prior comorbidities, new comorbidities, secondary malignancies, late relapse, and causes of death (COD) were documented. New comorbidities for chemotherapy only patients (n = 304) included renal disease (10%), and osteopenia/osteoporosis (38%) for HCT patients (n = 149). Incidence of hypertension was similar in the chemotherapy only cohort and chemotherapy + HCT cohort (14% vs 17%). Secondary malignancies occurred in 13%, commonly skin, prostate and breast cancers. Common COD included: secondary malignancy (4%), HCT complications (3%), and late relapses (5%). Overall, 12% had a late relapse. Median overall survival for chemotherapy only and HCT was 10.7 and 12.7 years, respectively. Long-term AML survivors need routine monitoring for comorbidities, secondary malignancies, and late relapses.