Background: Acute myeloid leukemia (AML) is the commonest type of leukemia in adults and the 6th highest cause of cancer-related death in males worldwide. There is a paucity of studies reporting treatment outcome of AML in developing countries, which prompted shedding light on challenges affecting survival of AML patients in Egypt.
Methods: This retrospective study investigated treatment outcomes of 90 AML patients treated during the period January 2010 – December 2014 at Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK) – Cairo University Hospital, Egypt.
Results: A complete remission rate of 65% was achieved (n=52), while refractory disease was documented in 11 patients (13.8%) and early mortality rate was 12.5%. Half of patients in remission eventually relapsed and the estimated overall survival (OS) was 11.5 months (95% CI: 6 – 17). Hyperleukocytosis at presentation imposed poor response to chemotherapy (p- 0.047) and short OS (p- 0.003), while poor performance status was the prominent clinical factor affecting OS (p- 0.02). Interruption of induction therapy significantly impaired response rate (p- 0.003) and incomplete consolidation treatment had an adverse impact on both disease free- and overall survival (p- <0.001). Complete remission after salvage therapy was associated with improved OS (p-value 0.025).
Conclusion: There is an urgent need for availability of resources as optimal supportive care, routine testing of cytogenetic and molecular markers, and allogeneic stem cell transplantation. These advancements will allow for better risk-adapted therapy, timely delivery of treatment and reduction in morbidity and mortality of Egyptian patients.
Acute myeloid leukemia (AML), Leukocytosis; Survival; Body mass index (BMI); Treatment; Relapse; Egypt.