Outcome of Adolescents and Young Adults with Acute Myeloid Leukemia: A Single-Center Experience

Ahmed Embaby, A. Fathy, Mohammad Al-Akkad, A. Baraka, Haitham Elsheikh
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Abstract

Abstract Introduction: Little is known about the outcomes of Adolescent and young adults (AYAs); aged 15-39 years with acute myeloid leukemia (AML) worldwide, so, we evaluated the clinical characteristics, response to therapy, and survival outcomes of these patients. Patients and Methods: In this observational prospective cohort study, we investigated 64 AYA AML patients, divided by their age at diagnosis into two groups, (AYA 16-29 years) and (AYA 30-39 years); including 26 and 20 patients, respectively. Patient and disease characteristics, in addition to treatment and survival outcomes, were analyzed using statistical package for social science software version 24 Results: The median age of the whole group was 29 years, with male-to-female ratio 1.3. The most common FAB subtypes were M2 and M4, 30.4% (for each subtype). Normal karyotyping represented the most frequent cytogenetic risk group (65.2%). An intensive induction therapy was given to most patients (82.6%) and a significant difference was found between the 2 patient groups regarding karyotyping and intensive induction therapy, P-value <0.001 and 0.048, respectively. The complete remission rate was (65.2%) and the relapse rate was 40.0% which was significantly higher in the (AYA 16-29 year) group, P<0.001. The 3-Year leukemia-free survival (LFS) rate was 23.6% and was significantly better within the (AYA 30-39 years) group, p-value = 0.002. While there was no significant difference in overall survival rates. Conclusion: AYA patients constitute a unique subset of patients with AML with an improved prognosis especially those aged from 30-39 years, who had better LFS and lower relapse rates. Keywords: Adolescent and young adults (AYAs), acute myeloid leukemia (AML), survival, prognosis.
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青少年和青年急性髓性白血病的预后:单中心经验
摘要引言:关于青少年和青壮年(AYAs)的结局知之甚少;因此,我们评估了这些患者的临床特征、对治疗的反应和生存结果。患者和方法:在这项观察性前瞻性队列研究中,我们调查了64例AYA AML患者,根据诊断时的年龄分为两组(AYA 16-29岁)和(AYA 30-39岁);分别包括26例和20例患者。采用社会科学软件version 24对患者及疾病特征、治疗及生存结果进行统计分析。结果:全组平均年龄29岁,男女比1.3。最常见的FAB亚型为M2和M4,各占30.4%。正常核型是最常见的细胞遗传风险组(65.2%)。大多数患者接受强化诱导治疗(82.6%),两组患者核型和强化诱导治疗差异有统计学意义,p值分别<0.001和0.048。完全缓解率(65.2%)和复发率(40.0%)明显高于(AYA 16 ~ 29年)组,P<0.001。3年无白血病生存率(LFS)为23.6%,AYA组(30 ~ 39年)显著优于AYA组(p值= 0.002)。而总体生存率无显著差异。结论:AYA患者是AML患者中预后改善的一个独特亚群,特别是年龄在30-39岁之间的患者,其LFS较好,复发率较低。关键词:青少年,急性髓性白血病,生存,预后。
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