Vemprala Arushi, Gajendra Smeeta, Gupta Ritu, Thakral Deepshi, Bakhshi Sameer, Sahoo Ranjit K, Seth Rachna, Upadhyay Ashish Datt
Department of Laboratory Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, IND.
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2023 Dec 20;15(12):e50869. doi: 10.7759/cureus.50869. eCollection 2023 Dec.
Complete diagnosis of acute myeloid leukemia (AML) requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping, karyotyping, and molecular genetic testing. The study intends to evaluate the demographic profile, clinical workup, and investigation, including flow cytometric immunophenotyping, in adult and pediatric age groups of AML.
This is a retrospective study of AML patients treated between January 2017 and December 2021. Clinical and demographic characteristics and investigation findings were recorded from case files and the hematology database.
A total of 896 cases of AML were registered during the given period, of which 819 cases were de-novo AML. Among those 819 cases, more than two-thirds of cases, i.e., 78.9% (N = 646), received induction chemotherapy. A significantly higher male-to-female ratio was observed (1.5:1). The median age was 22 years. The median time for diagnosis was three days and the median time for treatment intervention was four days. There were significant differences in the Eastern Cooperative Oncology Group (ECOG) performance status scores between pediatric and adult AML patients. Pediatric AML patients presented with better ECOG performance scores (ECOG performance scores 0 and 1) than adult patients (74.76% vs. 43.14%, p < 0.001). Further comparing adult vs. pediatric AML patients, normal karyotype (60.56% vs. 31.93%, p < 0.001) and NPM1 (22.25% vs. 6.72%, p < 0.001) and FLT3-ITD mutations (20.28% vs. 7.98%, p<0.001) were more common in the adult group, whereas AML-ETO (40.76% vs. 16.34%, p < 0.001) was more common in the pediatric group.
The study highlights the presenting age is lower than global figures. The median time for initial diagnosis and the start of treatment is within the acceptable norms. Normal karyotype and NPM1 and FLT3 mutations were common in adult AML patients, whereas AML-ETO was more common in the pediatric cohort. These findings will help plan prospective studies and see the correlation with treatment outcomes. The laboratory workup practice currently complies with the standard guidelines at our center.
急性髓系白血病（AML）的完整诊断需要结合临床信息以及形态学评估、免疫表型分析、核型分析和分子遗传学检测。本研究旨在评估AML成人和儿童年龄组的人口统计学特征、临床检查及包括流式细胞术免疫表型分析在内的各项检查。
这是一项对2017年1月至2021年12月期间接受治疗的AML患者的回顾性研究。从病例档案和血液学数据库中记录临床和人口统计学特征以及检查结果。
在给定期间共登记了896例AML病例，其中819例为初发AML。在这819例病例中，超过三分之二的病例，即78.9%（N = 646）接受了诱导化疗。观察到男性与女性比例显著更高（1.5:1）。中位年龄为22岁。诊断的中位时间为三天，治疗干预的中位时间为四天。儿童和成人AML患者在东部肿瘤协作组（ECOG）体能状态评分上存在显著差异。儿童AML患者的ECOG体能状态评分（ECOG体能状态评分0和1）优于成人患者（74.76%对43.14%，p < 0.001）。进一步比较成人与儿童AML患者，正常核型（60.56%对31.93%，p < 0.001）、NPM1（22.25%对6.72%，p < 0.001）和FLT3-ITD突变（20.28%对7.98%，p<0.001）在成人组中更常见，而AML-ETO（40.76%对16.34%，p < 0.001）在儿童组中更常见。
该研究强调发病年龄低于全球数据。初始诊断和开始治疗的中位时间在可接受范围内。正常核型以及NPM1和FLT3突变在成人AML患者中常见，而AML-ETO在儿童队列中更常见。这些发现将有助于规划前瞻性研究并观察与治疗结果的相关性。目前的实验室检查操作符合我们中心的标准指南。
