Long-term outcomes for patients with acute myeloid leukemia: a single-center experience from AIIMS, India

Abstract

Aim: To analyze clinicopathological characteristics of acute myeloid leukemia (AML) patients and to evaluate long-term outcome of these patients presented to single tertiary care center in India. Methods: We evaluated outcomes of 480 patients (age 8–60 years), classified into good, intermediate and poor risk according to cytogenetic results. Standard “3+7” induction therapy with dose of daunorubicin ranging from 45 to 90 mg/m² followed by two to three courses of high-dose cytarabine (12–18 g/m²) as consolidation therapy was given to majority. Results: The complete remission rate of the treated population (407 patients) was 70% with 84.8% in good risk, 67.9% in intermediate risk and 54.2% in poor risk (P = 0.0001). Induction mortality was 18.4%. One hundred twenty-nine patients relapsed with median treatment free interval of 10.4 months. At a median follow-up of 34.5 months, the median overall survival (OS) was 20.6 months with an estimated 5-year survival rate of 35.5%. No difference was found in OS between the three risk groups; however, patients with intermediate risk had a better leukemia-free survival (LFS) in comparison to good risk. Multivariate analysis showed age, performance status, treatment completion and hematopoietic stem cell transplant affecting OS, while only treatment completion affected LFS. Conclusion: This is one of the largest single-center studies reflecting more accurately the outcome of AML in India. These results are likely due to uniform treatment protocols, intensification of induction and post-remission treatments with comprehensive supportive care.