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Progress in management of acute myeloid leukaemia (AML) in Australia since 1980: a single institution retrospective study
Author(s) -
Thomas D. M.,
Seymour J. F.,
Szer J.,
Grigg A. P.,
Basser R. L.,
Green M. D.,
Fox R. M.
Publication year - 1998
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1998.tb02968.x
Subject(s) - medicine , context (archaeology) , myeloid leukaemia , retrospective cohort study , clinical trial , induction chemotherapy , transplantation , myeloid , pediatrics , chemotherapy , paleontology , biology
Background: Much research has been conducted into the pathobiology, diagnosis, and management of acute myeloid leukaemia (AML) since 1980, with major contributions from Australian studies in this period. Aims: To determine whether advances in basic and clinical research into AML have translated into improved survival for patients in the community. Methods: A retrospective survey of records of all patients with AML presenting to the Royal Melbourne Hospital (RMH) over a 16 year period, analysed according to induction therapy and established prognostic factors. Between 1980 and December 1996 223 (98%) of 227 patients were evaluable. ResuZts: The probability of survival at five years for patients treated since 1990 has improved significantly compared to the cohort treated between 1980‐89 (3455% vs 422%; meankstandard error). This benefit is most evident in patients less than 60 years of age (5057% vs 1124%). Successive induction protocols in the context of clinical trials conducted since 1985 contributed to improved outcomes. The selective application of bone marrow transplantation, and use of retinoic acid as induction therapy for acute promyelocytic leukaemia has also improved survival. Despite increases in dose‐intensity, early death rates for patients undergoing induction therapy fell during the study period. Conclusions: Participation in clinical and basic research with the development of more intense and specific treatments for patients with AML has contributed to better outcomes, underpinned by improvements in supportive care. (Aust NZ J Med 1998; 28: 190‐1 96.)