Abstract
The current study retrospectively evaluated cytogenetic profiles, various prognostic factors, and survival outcomes in 128 acute myeloid leukemia (AML) patients (14 ≤ age ≤ 70 years) admitted to the National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar, between January 2010 and December 2016. The median age at diagnosis was 43 years, and 80% were less than 60 years old; 75% of patients were male. Cytogenetic analysis was integrated into the World Health Organization 2008 classification and showed that the percentages of normal and abnormal karyotypes were similar, accounting for 48.4% of each group of patients. The AML risk stratification based on cytogenetic analysis resulted in the following distribution: 18% in the favorable risk group, 57% in the intermediate-risk group, 24% in the unfavorable risk group, and 1% unknown. Only 88 patients received therapy with curative intent; 67% achieved complete remission, increasing to 81% after inductions 1 and 2. The median overall survival (OS) and disease-free survival (DFS) in AML patients were 26.6 and 19.5 months, respectively. The 3-year OS and DFS were 40 and 36%, respectively. Prognostic factors including age, gender, white blood cell count, and risk stratification were not significantly associated with treatment outcomes, whereas response to treatment vs. failure was significantly associated with the outcome (p = 0.01). The current study supports the importance of cytogenetics as a useful tool in diagnosis, prognosis, and risk assessment in AML treatment.
Highlights
Abnormal growth of white blood cells (WBCs) in the bone marrow, typically known as acute myeloid leukemia (AML), usually hampers normal blood cell production
The current study is the first to be conducted on AML in Qatar from January 2010 until December 2016 for patients aged between 14 and 70 years old
It is the first of its kind to determine the cytogenetic abnormalities in AML in adults and to evaluate the risk stratification according to the WHO 2008 classification, and to report the clinical outcomes in Qatar
Summary
Abnormal growth of white blood cells (WBCs) in the bone marrow, typically known as acute myeloid leukemia (AML), usually hampers normal blood cell production. Intensity of AML is higher in the white population (3.8 per 100,000) than in Asian people (3.2 per 100,000) (Howlader et al, 2012). AML is a common type of blood cancer, accounting for 80% of all leukemias. Males are more likely to be affected than females. The risk of AML increases with age, in those above 60 years old. In the United States, the incidence of AML increases by around 10 times in patients above 65 years old, with a rate of 12.2 per 100,000 people (De Kouchkovsky and Abdul-Hay, 2016)
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