Clinical evaluation and response to treatment of patients with acute myeloid leukemia. Multicenter Study.

Abstract

In the last years advances on the treatment of acute myeloid leukemia (AML) have been limited, with no relevant changes. On the other side, there have been important improvements in genetic characterization leading to the concept of risk adapted treatment. This study aims to describe prognostic variables that influence survival and compare consolidation modalities of intermediate risk (IR) patients. We retrospectively evaluated 222 patients aged ≤75 years with AML from four Argentinian institutions between 2005 and 2015. Median overall survival was 11months (IQR 5.03-27.87). By cytogenetic, the IR group was more prevalent (51.4%) followed by adverse risk (AR) (23.4%) and low risk (LR) (11.7%). From a total of 198 patients (89.2%) who received 7/3 induction, 154 (77.7%) achieved complete remission (CR) and 21 (10.6%) died within 30 days from induction. By univariate analysis age, secondary AML, cytogenetic risk and lack of CR achievement were variables associated with worse prognosis; after running the multivariate model, lack of achievement CR after first line treatment was the variable that remained significant after 2 inductions (HR 7 95%CI 4.8-10) p=0.001. Consolidation modalities by frequency were: intensive chemotherapy 102 patients (69%), allogeneic transplantation 50 patients (29%) and supportive care 2 patients (2%). The analysis among IR group showed no survival difference between consolidation treatments (intensive chemotherapy vs. allogeneic transplant). This pilot study conducted without financial support, outside controlled clinical trials, provides real-world information on clinical and treatment aspects of AML and the authors consider it as a basis for generating further studies of greater complexity in the future.