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Long‐term outcomes for patients with acute myeloid leukemia: A single‐center experience from AIIMS , I ndia
Author(s) -
Bahl Ankur,
Sharma Atul,
Raina Vinod,
Kumar Lalit,
Bakhshi Sameer,
Gupta Ritu,
Kumar Rajeev
Publication year - 2015
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12333
Subject(s) - medicine , cytarabine , myeloid leukemia , daunorubicin , multivariate analysis , single center , induction chemotherapy , surgery , population , leukemia , hematopoietic stem cell transplantation , chemotherapy , transplantation , environmental health
Abstract Aim To analyze clinicopathological characteristics of acute myeloid leukemia ( AML ) patients and to evaluate long‐term outcome of these patients presented to single tertiary care center in I ndia. Methods We evaluated outcomes of 480 patients (age 8–60 years), classified into good, intermediate and poor risk according to cytogenetic results. Standard “3 + 7” induction therapy with dose of daunorubicin ranging from 45 to 90 mg/m 2 followed by two to three courses of high‐dose cytarabine (12–18 g/m 2 ) as consolidation therapy was given to majority. Results The complete remission rate of the treated population (407 patients) was 70% with 84.8% in good risk, 67.9% in intermediate risk and 54.2% in poor risk ( P = 0.0001). Induction mortality was 18.4%. One hundred twenty‐nine patients relapsed with median treatment free interval of 10.4 months. At a median follow‐up of 34.5 months, the median overall survival ( OS ) was 20.6 months with an estimated 5‐year survival rate of 35.5%. No difference was found in OS between the three risk groups; however, patients with intermediate risk had a better leukemia‐free survival ( LFS ) in comparison to good risk. Multivariate analysis showed age, performance status, treatment completion and hematopoietic stem cell transplant affecting OS , while only treatment completion affected LFS . Conclusion This is one of the largest single‐center studies reflecting more accurately the outcome of AML in I ndia. These results are likely due to uniform treatment protocols, intensification of induction and post‐remission treatments with comprehensive supportive care.