Jacob Sherin, Jacob Sajini Elizabeth, Suryanarayana Bettadpura Shamanna, Dutta Tarun Kumar
Samaritan Hospital, Pazhanganad, Ernakulam, 683562 India.
2Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India.
Indian J Hematol Blood Transfus. 2019 Jul;35(3):431-436. doi: 10.1007/s12288-018-1051-9. Epub 2018 Nov 26.
Acute myeloid leukemia has a poor outcome because of early deaths, high relapse rate and financial constraints. Our hospital provides care free of cost and this study assesses the short term outcome of acute myeloid leukemia in adults. The study was done from September 2013 to May 2015. All patients above 18 years of age were included. Cytarabine infusion 100 mg/m daily for 7 days and Daunorubicin 60 mg/m daily for 3 days was used for induction chemotherapy followed by three cycles of high dose cytarabine as post-remission therapy. One hundred and two patients were included in the study. 48% were males. The median age was 41 years. There was an intention to treat in 84 patients. 13 patients died before chemotherapy and 71 patients (57 non AML M3) received induction chemotherapy. 82% of them had a Eastern Cooperative Oncology Group performance score of ≤ 2. 28 (of 57 non AML M3) patients were alive after post-remission therapy (with 39% deaths during induction phase) and 15 of them were in remission after a median follow up of nine months. The overall event free survival at the end of the study was 22% (16 out of 71). Altogether, 63 out of 84 patients had died. Sepsis was considered as the cause of death in 46% of the patients, but the isolation of causative organism was limited (20%). The treatment outcomes of AML are poor at our centre and the current standard of care needs a significant improvement.
由于早期死亡、高复发率和经济限制,急性髓系白血病的预后较差。我院提供免费治疗,本研究评估了成人急性髓系白血病的短期预后。该研究于2013年9月至2015年5月进行。纳入所有18岁以上的患者。诱导化疗采用阿糖胞苷每日100mg/m²,共7天,柔红霉素每日60mg/m²,共3天,缓解后治疗采用三个周期的大剂量阿糖胞苷。102例患者纳入研究。48%为男性。中位年龄为41岁。84例患者有治疗意向。13例患者在化疗前死亡,71例患者(57例非急性早幼粒细胞白血病M3)接受了诱导化疗。其中82%的患者东部肿瘤协作组体能状态评分为≤2。57例非急性早幼粒细胞白血病M3患者中有28例在缓解后治疗后存活(诱导期死亡率为39%),其中15例在中位随访9个月后处于缓解状态。研究结束时总的无事件生存率为22%(71例中的16例)。84例患者中共有63例死亡。46%的患者被认为死于脓毒症,但致病微生物的分离情况有限(20%)。我院急性髓系白血病的治疗效果较差,目前的治疗标准需要显著改进。