((Rami Komrokji, MD))
The difference between de novo AML and secondary AML is that de novo AML is AML in a patient with no prior history of antecedent hematological disease, while secondary AML is used to describe both AML from specific genetic mutations or antecedent blood disorders, such as MDS or MDS/MPN, and therapy-related AML.
AML-MRC is defined as greater than or equal to 20% blasts in the peripheral blood or bone marrow, along with previously documented MDS or MDS/MPN, myelodysplasia-related cytogenetic abnormalities, or dysplasia present in 50% or more of the cells in at least 2 cell lines, unless an NPM1 mutation or biallelic mutation of CEBPA is present.
t-AML occurs after medical treatments such as radiation, immunosuppressive therapies, or chemotherapies.
AML is generally a disease of older people with an average age of onset of 68 years.
It is important to differentiate de novo AML from sAML because outcomes for patients with secondary AML are much worse and these patients need more consideration to get to transplant.
VYXEOS is indicated for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t‑AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.
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