Outcome of Induction Therapy in Adult Patients with Acute Myeloid Leukemia

Abstract

ABSTRACT:BACKGROUND: Treatment of patients with newly diagnosed acute myeloid leukemia (AML) has improved during the past decades due to the intensification of induction and post remission chemotherapies and due to the incorporation of autologous and allogeneic transplantation procedures. Untreated acute leukemia is a uniformly fatal disease with a median survival time shorter than 3 months. OBJECTIVE:To evaluate the outcome of induction and complications post induction in adult patients with Acute Myeloid Leukemia(AML) in Baghdad Teaching HospitalPATIENTS AND METHODS: A total of 47 patients diagnosed as de novo AML who had been admitted within twelve months from January till December 2012 in hematology unit of Baghdad Teaching Hospital were included. Treatment of the 47 eligible patients for remission induction with standard intensive treatment course consisted of the combination with standard-dose cytosine arabinoside 100 mg/m2/d continuous infusion on days 1-7, with of doxorubicin in a dose of 30mg/m2 over half an hour infusion on day 1-3.Response to therapy was assessed for complete remission or persistence of leukemic cell post induction. Pattern and severity of infections and their relationship with granulocytopenia. were analyzed.RESULTS:The patients had a mean age of of 36.7 years ranged from 14 to 72 years. Performance status in 15 patients was 0 or I while the majority (43) patients was with PS of II-IV at diagnosis according to WHO/ECOG performance status scale. Duration between symptoms of AML prior diagnosis till suspicion of a diagnosis of AML at a referring hospital and confirmation of the diagnosis at our institute have been assessed with( mean +SD) duration 32±22.1days.of the 47 patients 22(47%) achieved complete remission post first induction (CR1)and further 5(11%) patients have CR2(after second remission) and 20(42%) was refractory to treatment. Focus of infection during marrow hypoplasia have been identified in 26(59%) patients.CONCLUSION: Based on the current data ,the remission rate was nearly comparable to the results with other reports . Intensification of anthracyclins and identification of cytogenetic and other independent prognostic relevance are needed to obtain better results.