TREATMENT RESULTS AND PROGNOSTIC FACTORS IN DE NOVO ACUTE MYELOGENOUS LEUKEMIA IN ADULTS

Abstract

A total of 66 patients with primary AML (40 men, 26 women, Median age 50 years) and 29 patients whose disease subsequently relapsed (15 men, 14 women, Median age 53 years) were analyzed retrospectively. The patients were all treated in our hospital with the same chemotherapy regimen between March 1987 and February 2000. The remission rate of 87.8% was obtained in patients with fresh disease, whereas the rate was 51.7% in patients with relapsed disease. The respective median remission durations were 16 and 7 months, and the median survival times were 22 and 10 months. Remission duration was associated significantly with WBC count and number of post-induction chemotherapy courses in patients with fresh disease. Longer overall survival was related to sex, WBC count, and number of post-induction courses in fresh cases. Multivariate analysis in relapsed cases revealed that the remission rate was associated with 1st remission duration. Achievement of the second remission was the sole significant factor for survival in relapsed cases. Based on these observations it was concluded that considerations on prognostic factors at the start of initial treatment would help in planning better total treatment strategies including stem cell transplantation.