Survival and Prognostic Factors in Adults Acute Myeloid Leukemia: A Retrospective Analysis of 119 Cases

Authors

  • Alina M Gridjac Faculty of General Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
  • Cristian Daniel Pirlog Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
  • Anca Simona Bojan Department of Hematology, Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania

DOI:

https://doi.org/10.5195/ijms.2013.207

Keywords:

Acute Myeloid Leukemia, Survival Analysis, Prognosis, Risk Assessment, Age Factor

Abstract

Background: Acute myeloid leukemia (AML) is a malignant disease with significant identified prognostic factors. Therefore our aim was to develop an Assessment Scheme of Prognosis in AML based on prognostic factors. In some counties, such as Romania or other less-highly developed countries, this scheme would be beneficial particularly when cytogenetic testing is unavailable or time-intensive.

Methods: We analyzed 119 adult patients with AML during a five year-period from a single-center in Romania. We retrospectively collected and analyzed data with Epi Info and Excel using patient medical records.

Results: According to age, the group A1 (<60 years) had a 40 months survival, in contrast with the group B1 (?60 years) with a survival of 19 months (p=0,0063). The group A2 (secondary AML) survived 15 months, whereas the group B2 (AML de novo) survived 40 months (p=0.0021). Additionally, the group A3 (mild comorbidities) achieved a 40 months survival, the group B3 (moderate comorbidities) survived 19 months, whereas the group C3 (severe comorbidities) survived 7 months (p=0,0059). According to WBC and blast number, the group A4 (high levels) had a 25 months survival, whereas the group B4 (low levels) survived 40 months (p=0,0057).

Conclusion: The prognostic factors studied are useful to identify the risk level of AML disease for each patient at diagnosis. We developed an assessment scheme of prognosis with three risk groups according to age, secondary AML, comorbidity, WBC and blasts and cytogenetic examination.

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Author Biography

Alina M Gridjac, Faculty of General Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

Alina Gridjac is a 6th year me­dical student at Faculty of Ge­neral Medicine, University of Medicine and Pharmacy “Iu­liu Hatieganu”, Cluj-Napoca, Romania

References

1. Kaushansky K, Lichtman MA, Beutler E, et al. Williams Hematology 8-th edition. New York, The McGraw Hill Companies Editure, 2010.
2. Liesveld JL, Lichtman MA. Acute Myelogenous Leukemia, In: Williams Hematology, 8-th edition, New York, The McGraw Hill Companies Editure, 2010, pp.1277-1312.
3. Schneider F, Hoster E, Schneider S, Dufour A, Benthaus T, Kakadia PM, et al. Age-dependent frequencies of NPM1 mutations and FLT3-ITD in patients with normal karyotype AML (NK-AML). Ann Hematol. 2012; 91(1):9-18.
4. Hartmut D, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European Leukemia. Blood. 2010;115(3):453-74.
5. Kurosawa S, Yamaguchi T, Miyawaki S, Uchida N, et al. Prognostic factors and outcomes of adult patients with acute myeloid leukemia after first relapse. Haematologica 2010;95(11)1857-64.
6. Wagner K, Damm F, Thol F, et al. FLT3-internal tandem duplication and age are the major prognostic factors in patients with relapsed acute myeloid leukemia with normal karyotype. Haematologica 2011;96(5):681-6.
7. Schellongowski P, Staudinger T, Kundi M, et al. Prognostic factors for intensive care unit admission, intensive care outcome, and post-intensive care survival in patients with de novo acute myeloid leukemia: a single center experience. Haematologica 2011;96(2):231-7.
8. Petrie K, Zelent A, Waxman S. Differentiation therapy of acute myeloid leukemia: past, present and future. Curr Opin Hematol 2009;16(2):84–91.
9. Colovic N, Tomin D, Vidovic A,et al. Pretreatment prognostic factors for overall survival in primary resistant acute myeloid leukemia. Lancet Oncol 2011;11(6):543-52.
10. Pulte D, Gondos A, et al. Expected long-term survival of patients diagnosed with acute myeloblastic leukemia during 2006–2010. Annals of Oncology 2010;21(2):335–41.
11. Larson R, et al. Is secondary leukemia an independent poor prognostic factor in acute myeloid leukemia?. Best Pract Res Clin Haematol. 2007;20(1):29-37.
12. Breccia M, Frustaci AM, Cannella L. Comorbidities and FLT3-ITD Abnormalities as Independent Prognostic Indicators of Survival in Elderly Acute Myeloid Leukaemia Patients. Hematol Oncol 2009;27(3):148-53.
13. Sorror ML, Storb R, et al. Role of Comorbidities in Optimizing Decision-Making for Allogeneic Hematopoietic Cell Transplantation. Mediterr J Hematol Infect Dis 2010;2(2):e2010015.
14. Marbello L, Ricci F, Nosari A, et al. Outcome of hyperleukocytic adult acute myeloid leukaemia:A single-center retrospective study and review of literature. Leuk Res. 2008;32(8):1221-7.
15. Gulley M, Shea T, Fedoriw Y,et al. Genetic Tests To Evaluate Prognosis and Predict Therapeutic Response in Acute Myeloid Leukemia. J Mol Diagn 2010;12(1):3-16.
16. Mrozek K, Marcucci G, Pascha P, et al. Clinical relevance of mutations and gene-expression changes in adult acute myeloid leukemia with normal cytogenetics: are we ready for a prognostically prioritized molecular classification?. Blood 2007;109(2):431-48.

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Published

2013-08-31

How to Cite

Gridjac, A. M., Pirlog, C. D., & Bojan, A. S. (2013). Survival and Prognostic Factors in Adults Acute Myeloid Leukemia: A Retrospective Analysis of 119 Cases. International Journal of Medical Students, 1(2), 70–73. https://doi.org/10.5195/ijms.2013.207

Issue

Vol. 1 No. 2 (2013)

Section

Original Article

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