Late relapses in acute myeloid leukemia: Analysis of characteristics and outcome

Relapse after 5 years of complete remission (CR) is uncommon in acute myeloid leukemia (AML). Among 2347 patients seen between 1980 and 2008, 1366 achieved CR; 942 relapsed. Eleven (1.16 of all relapses) relapsed after a CR of>5 years. The median age was 66 years (range, 3779). Initial therapy was cytarabine plus anthracycline in six, amsacrine-based in three, and other in two. The median CR1 duration was 81 months (range, 60137). At relapse, the karyotype was different from the initial finding in five of eight (63) patients with available data. Treatment for relapse included cytarabine with anthracycline in eight, and other in three patients, with a second CR (CR2) achieved in four (36). The median CR2 duration was 1 month (range, 037), and median survival after relapse was 6.4 months (range, 139). Late relapses in AML are infrequent, with poor response to therapy. Karyotype at relapse is frequently different, raising the question of second AML versus relapse with the original clone.