The term secondary AML refers to two separate entities.
One type derives from a hematologic malignancy, most commonly myelodysplastic syndrome (MDS), that progresses to leukemia.
The second type of secondary AML is related to therapy that patients received for other malignancies.
Symptoms of secondary AML are similar to those of de novo acute leukemia.
Secondary AML, can be more indolent, however, as patients with secondary AML from MDS may not have a sudden onset illness typically associated with leukemia.
Usually presents as they slowly progressive 13 with easy bruise ability and bleeding.
Secondary AML is associated with a poor prognosis than those with other types of acute leukemia.
Secondary AML is almost universally fatal without bone marrow transplantation.
Secondary AML tends to be associated with genetic and molecular abnormalities with poor prognosis.
Rarely, cases of therapy-related AML have a better genetic profile.
Standardofcare presently is liposomal daunorubicin and cytarabine for newly diagnosed therapy-related AML or AML with myelodysplasia related changes.
Patients with secondary AML who are FLT3-positive can receive standard induction plus FLT3 inhibitor.