{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:18:44Z","timestamp":1767860324262,"version":"3.49.0"},"reference-count":54,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2017,4,7]],"date-time":"2017-04-07T00:00:00Z","timestamp":1491523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007313","name":"University of Texas MD Anderson Cancer Center","doi-asserted-by":"publisher","award":["P30 CA16672"],"award-info":[{"award-number":["P30 CA16672"]}],"id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P01 CA049639"],"award-info":[{"award-number":["P01 CA049639"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,8,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The development of newer strategies to improve outcomes for older patients with secondary acute myeloid leukemia (s\u2010AML) is a critical unmet need. Establishing baseline metrics for evaluating newer approaches is important.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>s\u2010AML was defined as 1 or more of the following: a history of an antecedent hematologic disorder (AHD), a diagnosis of therapy\u2010related acute myeloid leukemia (AML), and AML with karyotype abnormalities characteristic of myelodysplastic syndrome. Newly diagnosed s\u2010AML patients aged 60 to 75 years were grouped into 5 treatment cohorts: 1) patients receiving high\u2010 or intermediate\u2010dose cytarabine\u2013based intensive chemotherapy (IC), 2) patients receiving a hypomethylating agent (HMA) or HMA combinations, 3) patients receiving low\u2010dose cytarabine (LDAC) combinations, 4) patients receiving CPX\u2010351, and 5) patients receiving investigational (INV) agents. Nine hundred thirty\u2010one patients met the age and s\u2010AML criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Complete remission rates were statistically lower in the HMA group (36%) versus the IC (46%), CPX\u2010351 (45%), and LDAC groups (43%). Patients receiving less intensive regimens (the HMA and LDAC groups combined) had superior overall survival (OS) in comparison with patients receiving IC\u2010based regimens (median 6.9 vs 5.4 months; <jats:italic>P<\/jats:italic> = .048). Only 4.3% of the IC patients proceeded to transplantation, whereas 10.3% of the patients on lower intensity regimens did (<jats:italic>P<\/jats:italic> = .001). There was no difference in median survival between patients treated with CPX\u2010351 and patients treated with conventional lower intensity approaches (<jats:italic>P<\/jats:italic> = .75). Age &gt; 70 years, an adverse karyotype, and a prior AHD were associated with decreased OS in a multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Lower intensity approaches are associated with lower early mortality rates and improved OS in comparison with intensive regimens. OS is poor with currently available therapies with a median OS of 6 months (5.4\u20107.6 months across regimens). Unsatisfactory outcomes with other INV agents underscore the need for more effective therapies. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:3050\u201360.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30704","type":"journal-article","created":{"date-parts":[[2017,4,7]],"date-time":"2017-04-07T08:59:04Z","timestamp":1491555544000},"page":"3050-3060","source":"Crossref","is-referenced-by-count":52,"title":["Characteristics and outcomes of older patients with secondary acute myeloid leukemia according to treatment approach"],"prefix":"10.1002","volume":"123","author":[{"given":"Prajwal Chaitanya","family":"Boddu","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagop M.","family":"Kantarjian","sequence":"additional","affiliation":[{"name":"Department of 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