Leucemia Mielóide Agura: perfil de duas décadas do Serviço de Hematologia do Hospital das Clínicas de Porto Alegre - RS

Abstract

We have treated many AML patients in the last 20 years. We followed, between March 1980 and December 1999, 195 patients with ages ranging from 12 to 70 years and presenting de novo AML, excluding the M3 subtype. In the eighties, 102 patients are on record: 47 males and 55 females. Among these, 84 received induction chemotherapy with Cytarabin plus Daunorrubicin (7+3), resulting in a 51% (43/84) remission rate. The average disease-free and overall survival was 35% at 10 months and 13% at 12 months. Forty-one new diagnoses were performed from January 1990 and December 1993, all patients were submitted to the 7+3 chemotherapy protocol and a 66% remission rate was obtained. The disease free and overall survival rates were statistically (p < 0.001) higher with 41% of the patients at 7.6 months and 17.5% at 22 months. In 1994 a new protocol was introduced under the guidance of the Brazilian Cooperative Group on Leukemia Studies (GCBEL). It recommended induction with Cytarabin + Idarrubicin followed by consolidation and two intensification cycles with high doses of Cytarabin. Between 1994 and 1999, 52 patients were included in this new protocol and the remission rate was 73% (p = 0.002). In 50% of these patients disease free survival was about 23.3 months, while the overall survival was 25% at 26 months. Both disease free survival and overall survival rates in the last period showed statistically significant differences when compared to the previous years. We observed a progressive improvement in remission and survival rates in the last decades, however the prolonged event-free survival stayed below 30%. Our results are similar to the national centers that treat AML and in accordance with the literature data.