Secondary acute lymphoblastic leukemia is an independent predictor of poor prognosis

Leuk Res. 2015 Dec;39(12):1342-6. doi: 10.1016/j.leukres.2015.09.011. Epub 2015 Sep 12.

Abstract

Compared to secondary acute myeloid leukemia, secondary acute lymphoblastic leukemia (sALL) is poorly characterized. We utilized data from the Surveillance, Epidemiology, and End Results (SEER) 13 database to further elucidate patient characteristics and prognostic factors in sALL. Cases of adult de novo acute lymphoblastic leukemia (ALL) and sALL in patients with primary breast, rectum, cervix, or ovarian cancers or lymphoma with a latency period of at least 12 months were identified within the SEER 13 database. Survival in sALL and de novo ALL were compared after propensity matching based on age, gender, race, ALL subtype, and year of diagnosis. 4124 cases of de novo ALL and 79 cases of sALL were identified. sALL patients were older at diagnosis (median 62 years vs. 44 years; p<0.01). Overall survival (OS) in sALL was lower than de novo ALL (median 8 months vs. 11 months), 1 year OS: 35% vs. 47% (p=0.05), 2 year OS: 16% vs. 31% (p<0.01), and 5 year OS: 7% vs. 21% (p<0.01). Multivariate analysis revealed sALL as an independent predictor of worsened survival (adjusted HR 1.54; 95% CI 1.16-2.04, p<0.01) after propensity matching.

Keywords: Prognosis; Secondary leukemia; Survival.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / adverse effects
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Leukemia, Radiation-Induced / mortality
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / mortality*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / classification
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / etiology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality*
  • Prognosis
  • Proportional Hazards Models
  • Racial Groups
  • Radiotherapy / adverse effects
  • Rectal Neoplasms / epidemiology
  • Rectal Neoplasms / therapy
  • SEER Program
  • Topoisomerase II Inhibitors / adverse effects
  • United States / epidemiology
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / therapy

Substances

  • Antineoplastic Agents, Alkylating
  • Topoisomerase II Inhibitors