AML-392: Experience in AML Treatment in a Public Tertiary Facility

Introduction AML is a clonal disease that originates in myeloid progenitor cells, with a variable overall survival depending on cytogenetic and mutational anomalies. Objective To characterize the adult AML population in a public hospital in Buenos Aires province and their outcomes after induction chemotherapy treatment. Materials and Methods We performed a retrospective descriptive analysis of patients older than 16 years with a diagnosis of AML (non-promyelocytic) in the time period between January 2014 to June 2019. Forty-four patients were included, who received either chemotherapy with a 7+3 regimen (cytarabine + anthracicline), hypomethilating agents (decitabine or azacitidine), or supportive treatment. Results The total population consisted of 47 patients, 62% (n=29) men and 38% (18) female. The median age was 43 years (IQR 16–79). A cytogenetic study was performed in 43 patients, of which 38 had a correct number of metaphases. According to the ELN 2017 classification, of these 38 patients, 5 (13%) were favorable risk, 23 (60%) were intermediate risk, and 9 (24%) were adverse risk. All patients had a immunophenotyping study at diagnosis. AML subtype was “AML not otherwise specified” in 32 patients (68%). Mutational analysis (mainly FLT3 and NPM1 status) could only be performed in a routine fashion starting from January 2018. Of the 47 patients, 44 received an induction regimen of 7+3, 2 received hypomethilation agents, and 1 received support treatment only. The median overall survival was 10 months. Of the 44 patients treated with intensive chemotherapy, 31 (70%) achieved CR after one induction regimen, while 18 (40.9%) required a second induction regimen, and 4 (9.0%) were primarily refractory. Nine (20.45%) patients who received intensive induction chemotherapy died. The nine patients who died during induction treatment had a mean age of 47.67 years and a median age of 43. Their mean performance status score was 2.3. Their mean leukocyte count at diagnosis was 90151.11/mm3 with a median of 9000/mm3. Conclusions The outcomes in our population are similar to those reported in the international literature as the number of patients reaching CR status after induction treatment, with our mortality in this stage still being high.