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Treatment of de novo acute myeloid leukaemia in Hong Kong: a twenty‐year experience (1975 to 1996)
Author(s) -
Chim C. S.,
Liang R.,
Kwong Y. L.,
Lie A. K. W.,
Todd D.,
Chan T. K.
Publication year - 1999
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.1445-5994.1999.tb01622.x
Subject(s) - medicine , mitoxantrone , myeloid leukaemia , chemotherapy , myeloid , retrospective cohort study , myeloid leukemia , gastroenterology , surgery
Background : Small patient numbers and short follow‐up are common in some acute myeloid leukaemia (AML) studies and data on secondary malignancies after treatment of AML are rare. Aims : To determine the prognostic factors and long‐term treatment results. Methods : A retrospective study of patients with de novo AML under the age of 60 over a 20‐year period in which two induction therapy regimens: 7:3 (1975–1983) and 7:3:7 (1984–1996) and three consolidation chemotherapy regimens: 5:2 (1975–1983), 5:2:5 (1984–1990) and Ara‐C/mitoxantrone (1991–1996) were used. Disease‐free (DFS), overall survivals (OS) and prognostic factors were analysed. Results : Two‐hundred and two of 276 (73%) patients attained complete remission (CR). The CR rates of 7:3 and 7:3:7 regimens were 70.5% and 74.5% respectively ( p =0.92). The median DFS was 12 months and the projected DFS at 10‐ and 20‐years were 23% and 21% respectively. For patients consolidated with 5:2, 5:2:5 and Ara‐C/ mitoxantrone, the median DFS was 15 m, 12 m and 11 m respectively and the projected ten‐year DFS were 27%, 21% and 18% respectively ( p =0.2). Ninety per cent of relapses occurred within two years from remission but there were two late relapses at 109 m and 120 m respectively. Young age and FAB M3 subtype were favourable prognostic factors to OS ( p =0.04) and DFS ( p =0.006) respectively. There was no secondary solid tumour in the long‐term survivors. Conclusion : Our experience confirmed the efficacy of standard‐dose Ara‐C/daunorubicin and the prognostic value of age and FAB subtype. Median and projected DFS were similar to western studies.