{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:59:21Z","timestamp":1790834361377,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"31","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Secondary and therapy-related acute myeloid leukemia (sAML and tAML, respectively) remain therapeutic challenges. Still, it is unclear whether their inferior outcome compared with de novo acute myeloid leukemia (AML) varies as a result of previous hematologic disease or can be explained by differences in karyotype and\/or age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In a Danish national population-based study of 3,055 unselected patients with AML diagnosed from 2000 to 2013, we compared the frequencies and characteristics of tAML, myelodysplastic syndrome (MDS) -sAML, and non-MDS-sAML (chronic myelomonocytic leukemia and myeloproliferative neoplasia) versus de novo AML. Limited to intensive therapy patients, we compared chance of complete remission by logistic regression analysis and used a pseudo-value approach to compare relative risk (RR) of death at 90 days, 1 year, and 3 years, overall and stratified by age and karyotype. Results were given crude and adjusted with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, frequencies of sAML and tAML were 19.8% and 6.6%, respectively. sAML, but not tAML, was associated with low likelihood of receiving intensive treatment. Among intensive therapy patients (n = 1,567), antecedent myeloid disorder or prior cytotoxic exposure was associated with decreased complete remission rates and inferior survival (3-year adjusted RR for MDS-sAML, non-MDS-sAML, and tAML: RR, 1.14; 95% CI, 1.02 to 1.32; RR, 1.27; 95% CI, 1.16 to 1.34; and RR, 1.16; 95% CI, 1.03 to 1.32, respectively) compared with de novo AML. Among patients \u2265 60 years old and patients with adverse karyotype, previous MDS or tAML did not impact overall outcomes, whereas non-MDS-sAML was associated with inferior survival across age and cytogenetic risk groups (adverse risk cytogenetics: 1-year adjusted RR, 1.47; 95% CI, 1.23 to 1.76; patients \u2265 60 years old: 1-year adjusted RR, 1.31; 95% CI, 1.06 to 1.61).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results support that de novo AML, sAML, and tAML are biologically and prognostically distinct subtypes of AML. Patients with non-MDS-sAML have dismal outcomes, independent of age and cytogenetics. Previous myeloid disorder, age, and cytogenetics are crucial determinants of outcomes and should be integrated in treatment recommendations for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2014.60.0890","type":"journal-article","created":{"date-parts":[[2015,8,24]],"date-time":"2015-08-24T22:03:48Z","timestamp":1440453828000},"page":"3641-3649","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":412,"title":["Epidemiology and Clinical Significance of Secondary and Therapy-Related Acute Myeloid Leukemia: A National Population-Based Cohort Study"],"prefix":"10.1200","volume":"33","author":[{"given":"Lene Sofie","family":"Granfeldt \u00d8stg\u00e5rd","sequence":"first","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. Medeiros, Stanford University School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno C.","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. Medeiros, Stanford University School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Sengel\u00f8v","sequence":"additional","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. Medeiros, Stanford University School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"N\u00f8rgaard","sequence":"additional","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. Medeiros, Stanford University School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette Klarskov","family":"Andersen","sequence":"additional","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. Medeiros, Stanford University School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge H\u00f8gh","family":"Dufva","sequence":"additional","affiliation":[{"name":"Lene Sofie Granfeldt \u00d8stg\u00e5rd, Mette N\u00f8rgaard, Eigil Kjeldsen, and Jan Maxwell N\u00f8rgaard, Aarhus University Hospital, Aarhus; Henrik Sengel\u00f8v, Mette Klarskov Andersen, and Lone Smidstrup Friis, The University Hospital Rigshospitalet, Copenhagen; Inge H\u00f8gh Dufva, Herlev University Hospital, Herlev; Claus Werenberg Marcher and Birgitte Preiss, Odense University Hospital, Odense; Marianne Severinsen, Aalborg University Hospital, Aalborg, Denmark; and Bruno C. 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