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Ethnicity and prognosis in acute myeloid leukemia
Author(s) -
Alcalai Ronny,
BenYehuda Dina,
Ronen Ilana,
Paltiel Ora
Publication year - 2003
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10270
Subject(s) - medicine , multivariate analysis , myeloid leukemia , univariate analysis , oncology , population , ethnic group , survival analysis , environmental health , sociology , anthropology
Ethnicity has been described as a prognostic factor in breast cancer and in childhood acute lymphocytic leukemia but not in adult acute myeloid leukemia (AML). We reviewed the records of 225 consecutive AML patients who were diagnosed and treated between 1983 and 1995. Data were collected concerning demographic factors, presenting clinical features, and treatment protocols. We categorized ethnicity as follows: European Jews, non‐European Jews, and Arabs. We assessed the role of ethnicity controlling for other known prognostic factors on treatment outcome and survival in this population. Older age, high leukocyte count at diagnosis, and high‐risk chromosomal aberrations were significantly associated with overall survival in univariate analysis. In multivariate analysis high leukocyte count and high‐risk chromosomal aberrations exerted an independent negative effect on survival. European origin was associated with longer event‐free survival in univariate analysis ( P = 0.024) and longer overall ( P < 0.01) and event‐free ( P < 0.01) survival but not with a higher remission rate in multivariate analysis. For AML patients who achieved remission after induction chemotherapy and survived its complications, European origin is an independent favorable prognostic factor for long‐term remission and survival in Israel. These findings may reflect better socioeconomic status, social support, increased compliance with treatment protocols, or better psychological coping mechanisms with malignancy. Am. J. Hematol. 72:127–134, 2003. © 2003 Wiley‐Liss, Inc.