Among patients with myeloproliferative neoplasms, men with primary myelofibrosis diagnosed after 2006 are at the highest risk of developing secondary acute myeloid leukemia (AML), according to a study published in conjunction with the 2016 annual meeting of the American Society of Clinical Oncology (ASCO).1

For the study, researchers analyzed data from 9335 patients with polycythemia vera (43.8%), primary myelofibrosis (11.8%), and essential thrombocythemia (44.4%) diagnosed between 2000 and 2012 and included in the Surveillance, Epidemiology, and End Results (SEER) database to determine the risk of secondary AML in this patient population.

With a median follow-up of 48 months, results showed that 83 patients developed secondary AML. Median age at diagnosis of AML was 72 years, 69% were male, and 80% were white.

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Researchers found that the cumulative incidence of secondary AML was 0.74% (95% CI, 0.56-0.97) and 1.62% (95% CI, 1.24-2.09) at 5 and 10 years, respectively. The 10-year cumulative incidence was higher in patients with primary myelofibrosis (2.96%; 95% CI, 1.90-4.39) compared with those with essential thrombocythemia (1.68%; 95% CI, 1.03-2.62) and polycythemia vera (1.24%; 95% CI, 0.81-1.83) (P <.001).

The study further demonstrated that the 10-year cumulative incidence was higher in males than females (P <.001) and in patients older than 60 years vs those 60 years or younger (P =.04).

These findings may be used to enhance education of patients with myeloproliferative disorders at risk for developing a secondary hematologic malignancy.


1. Paluri S, Giri S, Shrestha R, et al. Secondary acute myeloid leukemia (sAML) in patients with myeloproliferative disorder (MPD). J Clin Oncol. 2016;34(suppl):Abstr e18513.