Clinical and epidemiological characteristics of acute myeloid leukemias in adults according to the data of municipal hematology departments in Moscow

Full Text

Abstract

Aim. To estimate the incidence of acute myeloid leukemias (AML) in Moscow adults and to evaluate the efficiency of their treatment. Subjects and methods. Data on Moscow residents who were first diagnosed with AML in 2010 were retrospectively collected. The efficiency of their treatment was evaluated from the rates of complete remissions (CR), recurrences, deaths, and 4-year overall (OS) and relapse-free survival (RFS). The data as of September 1, 2013, were analyzed. Results. According to the 2010 pooled materials of the city’s municipal hematology departments, AML (non-M3 types) was diagnosed in 286 patients whose median age at diagnosis was 64.9 years (range, 18.2-92.0 years). The notified incidence rate was 2.9 (3.3 for men and 2.6 for women) cases per 100,000 population. 118 (41%) patients received intensive chemotherapy (ICT); 119 (42%) had chemotherapy with low-dose cytarabine (LDC); 7 (2%) had that with hypomethylating agents (HA); and 42 (15%) had palliative therapy (PT). During first-line therapy, none of the patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the entire group, the early (within the first 60 days) mortality rates were 42% (119 deaths); that of patients with primary refractory disease was 32% (90 deaths). CR was achieved in 77 (27%) patients: 57 (48%) on ICT, 17 (14%) on LDC, and 3 (43%) on HA. Recurrences occurred in 37 (48%) of the 77 patients who had achieved CR at a median follow-up of 43.9 months. Four-year OS in all the patients receiving PT was 9.8±1.9% (18.2±3.9% in the patients on ICT versus 4.5±2% in those of LDC; p=0.028); 4-year RFS was 36.1±5.7% (39.6±6.7% in the patients on ICT versus 31.3±11.6% in those on LDC; p=0.8). Conclusion. High mortality rates in the induction, which are caused by the limited resources of accompanying therapy, poor sanitary conditions, and no own opportunities to perform allo-HSCT, remain a key problem of AML therapy in adults.

References

  1. Derolf AR, Kristinsson SY, Andersson TM, Landgren O, Dickman PW, Björkholm M. Improved patient survival for acute myeloid leukemia: a population-based study of 9729 patients diagnosed in Sweden between 1973 and 2005. Blood. 2009;113(16):3666-3672.
  2. Polednak AP. Recent improvement in completeness of incidence data on acute myeloid leukemia in US cancer registries. J RegistryManag. 2014;41(2):77-84.
  3. Злокачественные новообразования в России в 2012 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена Минздрава России; 2014:250.
  4. Kantarjian H, O’Brien S. Questions regarding frontline therapy of acute myeloid leukemia. Cancer. 2010;116(21):4896-4901.
  5. Паровичникова Е.Н., Троицкая В.В., Клясова Г.А., Кузьмина Л.А., Соколов А.Н., Парамонова Е.В., Галстян Г.М., Кессельман С.А., Дроков М.Ю., Васильева В.А., Обухова Т.Н., Куликов С.М., Савченко В.Г. Лечение больных острыми миелоидными лейкозами по протоколу российского многоцентрового рандомизированного исследования ОМЛ-01.10: результаты координационного центра. Терапевтический архив. 2014;86(7):14-23.
  6. Грицаев С.В., Мартынкевич И.С., Кострома И.И., Карягина Е.В., Низамутдинова А.С., Мартыненко Л.С., Петрова Е.В., Тиранова С.А., Потихонова Н.А., Абдулкадыров К.М. Результаты лечения больных острыми миелоидными лейкозами в возрасте 60 лет и старше. Клиническая онкогематология. 2012;5(4):355-360.
  7. Итоги Всероссийской переписи населения 2010 год «Население по возрасту и полу». Доступно по: http://moscow.gks.ru/wps/wcm/connect/rosstat_ts/moscow/ru/. Ссылка активна на 12.10.2013.
  8. Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C. Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. Ann Intern Med. 1985;103(4):620-625.
  9. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon, France: IARC Press; 2008.
  10. U.S. Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE). Version 4.0. Published May 28, 2009.
  11. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Statis Assn. 1958;53(282):457-481.
  12. Berty HP, Shi H, Lyons-Weiler J. Determining the statistical significance of survivorship prediction models. J Eval Clin Pract. 2010;16(1):155-165. doi: 10.1111/j.1365-2753.2009.01199.x.
  13. Ostgård LS, Nørgaard JM, Severinsen MT, Sengeløv H, Friis L, Jensen MK, Nielsen OJ, Nørgaard M. Data quality in the Danish National Acute Leukemia Registry: a hematological data resource. Clin Epidemiol. 2013;5:335-344. doi: 10.2147/clep.s48411.
  14. Burnett AK, Milligan D, Prentice AG, Goldstone AH, McMullin MF, Hills RK, Wheatley K. A comparison of low-dose cytarabine and hydroxyurea with or without all-trans retinoic acid for acute myeloid leukemia and high-risk myelodysplastic syndrome in patients not considered fit for intensive treatment. Cancer. 2007;109(6):1114-1124.
  15. Shah BK, Ghimire KB. Improved survival among older acute myeloid leukemia patients — a population-based study. Acta Oncol. 2014;53(7):935-938. doi: 10.3109/0284186x.2014.889851.

Copyright (c) 2015 Semochkin S.V., Tolstykh T.N., Arkhipova N.V., Ivanova V.L., Klyueva O.V., Lunin V.V., Misyurina E.N., Tumanova M.V., Khuazheva N.K.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

© 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies