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<p>The bidirectional occurrence of acute myeloid leukemia (AML) and plasma cell neoplasms (PCN) is rare, and clinical characteristics and survival outcomes remain poorly defined. We conducted a retrospective population-based study using the Surveillance, Epidemiology, and End Results (SEER) database (2000–2022). Patients diagnosed with both AML and PCN were identified and categorized based on diagnostic sequence. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using Kaplan–Meier methods and Cox proportional hazards models adjusting for demographic and clinical variables. The research cohort consisted mainly of elderly individuals (≥65 years old, 76.2%) and males (66.3%). The median survival time was 4.0 months (IQR: 1.0-13.0). Multivariable Cox regression analysis demonstrated that chemotherapy was associated with a significant survival benefit across all models of OS (Model III: HR = 0.54, 95% CI: 0.37-0.78, p = 0.001) and CSS (Model III: HR = 0.55, 95% CI: 0.35-0.85, p = 0.008). In contrast, radiotherapy showed no significant association with survival (all p&gt;0.5). Kaplan-Meier analysis confirmed a significant survival advantage for patients receiving chemotherapy (log-rank p &lt; 0.0001) but not for radiotherapy (log-rank p = 0.35). Subgroup analyses revealed that the protective effect of chemotherapy was consistent (all p for interaction &gt; 0.5).In this population-based cohort, chemotherapy receipt was associated with improved survival among patients diagnosed with both AML and PCN. Given the observational nature of the study and limitations inherent to registry-based treatment ascertainment, these findings should be interpreted cautiously and warrant confirmation in studies designed to account for treatment timing and confounding.</p>

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Clinical characteristics and prognosis of acute myeloid leukemia and plasma cell neoplasms with bidirectional occurrence: a retrospective population-based study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月8日

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  • Zhihong Tong,
  • Min Chen,
  • Ziyan Lv,
  • Xiaoqing Yi

摘要

The bidirectional occurrence of acute myeloid leukemia (AML) and plasma cell neoplasms (PCN) is rare, and clinical characteristics and survival outcomes remain poorly defined. We conducted a retrospective population-based study using the Surveillance, Epidemiology, and End Results (SEER) database (2000–2022). Patients diagnosed with both AML and PCN were identified and categorized based on diagnostic sequence. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using Kaplan–Meier methods and Cox proportional hazards models adjusting for demographic and clinical variables. The research cohort consisted mainly of elderly individuals (≥65 years old, 76.2%) and males (66.3%). The median survival time was 4.0 months (IQR: 1.0-13.0). Multivariable Cox regression analysis demonstrated that chemotherapy was associated with a significant survival benefit across all models of OS (Model III: HR = 0.54, 95% CI: 0.37-0.78, p = 0.001) and CSS (Model III: HR = 0.55, 95% CI: 0.35-0.85, p = 0.008). In contrast, radiotherapy showed no significant association with survival (all p>0.5). Kaplan-Meier analysis confirmed a significant survival advantage for patients receiving chemotherapy (log-rank p < 0.0001) but not for radiotherapy (log-rank p = 0.35). Subgroup analyses revealed that the protective effect of chemotherapy was consistent (all p for interaction > 0.5).In this population-based cohort, chemotherapy receipt was associated with improved survival among patients diagnosed with both AML and PCN. Given the observational nature of the study and limitations inherent to registry-based treatment ascertainment, these findings should be interpreted cautiously and warrant confirmation in studies designed to account for treatment timing and confounding.