Publication Only: Acute myeloid leukemia - Clinical
Acute myeloid leukemia (AML) is a potentially fatal hematological disease. Along with disease-related factors, patient-related factors, in particular age, are a strong predictor of outcome that influence treatment decisions.
We performed a single-center retrospective study of a cohort of patients with LAM. We analyzed the different clinical, biological and evolutionary characteristics of our patients and we looked for a correlation between its variables
This study investigated the impact of several factors on the short-term outcomes of intensive chemotherapy in a cohort of 136 Algerian patients with acute myeloid leukemia.
n=136 pts between 2005 and 2018, n = 85 males / 51 females, sex ratio = 1.66, mean age = 53 ± 19 years (18-91), n = 40 pts are 65 or older (29%), diagnosis is made after an average of 28 days (1-45). n = 29 pts presented bone pain at diagnosis (21%), anemic syndrome: n = 130 (96%), haemorrhagic syndrome: n = 74 (54%), infectious syndrome: n = 58 (42%), a tumor syndrome:n = 26 (19%), splenomegaly: n = 29 (21%), this parameter is correlated with the cytological type (p=0.000 (s)). Secondary AML: n = 04 cases (3%) with a predominance (in these types) of forms without maturation: p=0.000 (s).The mean rate of GB = 41.126 ± 79238 / mm3 (300-707.900), the Hb level (avg) = 7.7 ± 2.7 g / dl (02-14), the plq rate (avg) = 57.665 ± 53.683 / mm3 (1000-315.000), the percentage of circulating blasts = 45 ± 31 (0-100): it is correlated with the cytological type, p=.000 (s). According to FAB classification: LAM0: n = 08 (06%), LAM1: n = 14 (10%), LAM2: n = 41 (30%), LAM3: n = 16 (12%), LAM4: n = 28 (21%) of which n = 02 LAM4eo, LAM5: n = 10 (07%), LAM6:n = 08 (06%), LAM7: n = 01 (0.7%), biphenotypic acute leukemia: n = 01 (0.7%), LAM unclassifiable:n = 09 (07%).We found a positive correlation between the type of AML is the age, p=0.002 (the AML2 are more frequent in the patients <65 years) but no correlation between this parameter and the sex: p = 0.92 (ns)n = 45 patients had an LDH level> 40 IU / L (33%), a metabolic complication in: n = 46 cases (it is correlated with the type (LAM2 +++): p=0.04 (s), uric acid = 55.2 ± 31.43 (12-162) mg/l. Transfusion support is provided, during the induction phase, the consumption of packed cells is evaluated at: n = 08 ± 7.35 CGPF (0-44), for platelet concentrates, we observed a consumption: n = 21.49 ± 24.56 CSP (0-147), n = 03 ± 4.09 CUP (0-26). A strong correlation with the treatment received (3 + 7 vs other): p=0.008 (s) for erythrocyte concentrates, p=0.002 for platelet concentrates. n = 92 pts (68%) received specific treatment, with a (3+7) protocol in 73 cases (54%). n = 35 complete remission at the end of induction (26%), n = 61 failures (45%), n = 111 deaths (81%). OS at 24 months = 20%, at 38% at 5 y (fig.1), in a multivariate model: no influence of sex (p = 0,21), diagnostic delay (p = .12), age (p = 0.24), tumor syndrome (p = 0,21), leukocytosis> 50,000/mm3 (p = 0,21), metabolic complications (p = 0.12). The risk of death is correlated with the cytological type: p=0,03 (S), the highest percentage concerns in our study = AML1.n = 64 patients had associated comorbidities, which explains that only 54% of patients were able to benefit from an induction protocol (3+7). This factor has an impact on the risk of death (p=0.02 (s))
myeloblastic acute leukemia is a serious condition with a clinical picture dominated by signs of bone marrow failure, the mean age in our study is 53 years (lower than that reported in international series (age = 64 y).