{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:22:51Z","timestamp":1780449771179,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with secondary acute myeloid leukemia who previously received hypomethylating agents for prior myeloid neoplasms (HMA\u2010sAML) face a dismal prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors analyze the characteristics, therapeutic approaches, and outcomes of patients with HMA\u2010sAML from the Programa Espa\u00f1ol para el Tratamiento de Hemopat\u00edas Malignas (PETHEMA) registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 479 patients were included, mostly from prior myelodysplastic syndrome (84%). Frontline therapy consisted of intensive chemotherapy (IC) in 31%, low\u2010dose cytarabine\u2010based in 19%, supportive care and clinical trial 17% each, and HMA\u2010based therapy in 12% and 4% in venetoclax\u2010based regimen. Complete remission was achieved in 95 patients (27%), with higher rate among IC and venetoclax\u2010based groups (44% and 41%, respectively). The median overall survival (OS) was 4.93 months, with 7.68 months for IC patients, 7.82 months after HMA monotherapy, and 4.66 months after venetoclax\u2010based regimens. Patients who underwent allogeneic hematopoietic stem cell transplantation in first remission (<jats:italic>n<\/jats:italic>\u00a0=\u00a033, 9%) had a better survival outcome (median OS not reached). Multivariate analyses identified age (\u226565 years), Eastern Cooperative Oncology Group &gt;2, higher white blood cell count, and adverse risk cytogenetic as adverse prognostic factors, whereas <jats:italic>NPM1<\/jats:italic> mutation was a favorable factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with HMA\u2010sAML have a poor prognosis and suboptimal outcomes with conventional treatments, including BCL2 inhibitors, highlighting the need for clinical trials targeting this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35696","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T02:40:31Z","timestamp":1735872031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Treatment patterns and outcomes in secondary acute myeloid leukemia arising after hypomethylating agents: PETHEMA registry study"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6661-9631","authenticated-orcid":false,"given":"Pilar","family":"Lloret\u2010Madrid","sequence":"first","affiliation":[{"name":"Hospital Universitari i Polit\u00e8cnic La Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Boluda","sequence":"additional","affiliation":[{"name":"Hospital Universitari i Polit\u00e8cnic La Fe  Valencia Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria La Fe (IISLAFE)  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Mart\u00ednez\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Bergua","sequence":"additional","affiliation":[{"name":"Hospital San Pedro Alc\u00e1ntara  C\u00e1ceres 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