Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

Filho, João Tadeu Damian Souto; Portugal, Rodrigo de Souza; Loureiro, Monique Morgado; Pulcheri, Wolmar; Nucci, Márcio

doi:10.1590/s0100-879x2011007500058

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…The curves of OS and EFS were also correlated with certain prognostic factors as reported in the literature, such as age at diagnosis, FAB classification, cytogenetics, WBC count at diagnosis and evolution (primary and secondary). 11,12,14 A comparison of different curves was performed using the log-rank test and differences with p -value < 0.05 being considered statistically significant. The comparative analysis of the curves also included the Odds Ratio (OR) with respective 95% confidence intervals (95% CI).…”

Section: Methodsmentioning

confidence: 99%

Acute myeloid leukemia: survival analysis of patients at a university hospital of Paraná

Padilha

Souza

Matos

et al. 2015

Revista Brasileira de Hematologia e Hemoterapia

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ObjectiveThe aim of this study was to analyze the prognostic factors correlated with survival of patients with acute myeloid leukemia at the Hospital de Clínicas, Universidade Federal do Paraná between 2003 and 2009, as well as to investigate the clinical and epidemiological profile.MethodsThe overall survival and disease-free survival were statistically evaluated using the Kaplan–Meier method, the log-rank test and multivariate evaluation by Cox regression analysis.ResultsThe study population was predominantly younger than 60 years old (81,6%), had intermediate cytogenetic risk (40.8%), in first complete remission after induction chemotherapy (46.9%), with a white blood count at diagnosis of less than 30 × 109/L (57.1%) and de novo acute myeloid leukemia (62.2%). Survival curves showed that better prognosis was related to age below 60 years (median:12,4 months; p-value = 0,2227; Odds Ratio = 0,6676), good prognostic cytogenetic markers (median: 97.7 months; p-value = 0.0037; Odds Ratio = 0.4239) and white blood cell count at diagnosis of less than 30 × 109/L (median survival: 23.6 months; p-value = 0.0001; Odds Ratio = 0.3651). Regarding the French-American-British subgroups, the median overall survival was 23.5 months for M0, M1 and M2, 97.7 months for M3 and 7.4 months for M4, M5, M6, and M7 (p-value = 0.0288).ConclusionPrognostic factors strongly influenced patient survival, as well as guided treatment. Moreover, these factors were consistent with the available literature adjusted for the population in question.

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Section: Methodsmentioning

confidence: 99%

Acute myeloid leukemia: survival analysis of patients at a university hospital of Paraná

Padilha

Souza

Matos

et al. 2015

Revista Brasileira de Hematologia e Hemoterapia

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“…A leucometria mostrou influência sobre a evolução. Nas características epidemiológicas, foi constatada a importância da idade na distribuição dos casos de leucemias agudas, bem como o predomínio Leucemia aguda no Acre dos subtipos LMA-M3 e LLA-B, características compartilhadas com os dados já descritos em outros estudos 1,5,8,[21][22][23] .…”

Section: Discussionunclassified

“…Estudos brasileiros demonstraram sobrevida hospitalar ruim para LMA 1,2,8,18 , com sobrevida similar à descrita nos trabalhos internacionais 4,12,19,20 . Callera et al 9 , em São Paulo, observaram sobrevida hospitalar de 5 anos em 11,7% dos casos de LMA; Bittencourt et al 21 , no Rio Grande do Sul, relataram uma sobrevida hospitalar de 56 meses em 37% dos casos; e Souto et al 22 , no Rio de Janeiro, em uma série de casos no período de 2000 a 2008, relataram uma sobrevida hospitalar de 5 anos em 26% dos casos. No entanto, pesquisas de sobrevida hospitalar também evidenciaram que as alterações citogenéticas que ocorrem nesses casos são o principal fator prognóstico na sobrevida, como observado na LPA e na LMA tipo CBF positiva 23,24 .…”

Section: Introductionunclassified

Perfil clínico-epidemiológico e sobrevida hospitalar dos casos de leucemia aguda em um hospital de referência em Rio Branco, Acre, 2007-2014

Lomonaco¹,

Koifman

Freire

2021

Cad. saúde colet.

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Resumo Introdução A Unidade de Assistência de Alta Complexidade em Oncologia (UNACON) permite o tratamento de leucemias agudas no Acre. Objetivo Determinar o perfil clínico-epidemiológico e a sobrevida hospitalar de leucemias agudas tratadas na UNACON/Acre entre 2007 e 2014. Método É um estudo longitudinal e retrospectivo de pacientes com leucemias agudas entre 15/06/2007 e 31/12/2014, cujos prontuários médicos forneceram dados para a análise descritiva das variáveis e posterior análise de sobrevida acumulada em 1 ano e 2 anos (método Kaplan-Meier) e comparação das curvas de sobrevida (teste de log-rank). Resultados A sobrevida para leucemias mieloides agudas (LMA) foi de 30% e 32% em 1 e 2 anos, respectivamente, com pior sobrevida para pacientes masculinos, brancos, ≥ 20 anos de idade, leucometria < 20.000 células/mm3, desidrogenase lática ≥ 600 U/dl e subtipo diferente do M3. Para leucemias linfoides agudas (LLA), a sobrevida foi de 59% e 45% em 1 e 2 anos, respectivamente, com pior sobrevida para sexo feminino, ≥ 20 anos de idade e leucometria elevada. Em pacientes abaixo de 20 anos de idade com LLA, a melhor sobrevida foi observada na faixa etária de 2 a 9 anos. Conclusão Trata-se do primeiro estudo epidemiológico de sobrevida realizado no Acre para leucemias agudas com resultados coerentes com a literatura. Contudo, novas pesquisas deverão ser realizadas.

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“…Cases were classified according to de French-American-British (FAB) criteria [ 21 ]. The treatment regimens changed over time (Table 1 ) [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of bone marrow aspirates in patients with acute myeloid leukemia at day 14 of induction therapy

et al. 2015

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BackgroundEarly assessment of response to chemotherapy in acute myeloid leukemia may be performed by examining bone marrow aspirate (BMA) or biopsy (BMB); a hypocellular bone marrow sample indicates adequate anti-leukemic activity. We sought to evaluate the quantitative and qualitative assessment of BMA performed on day 14 (D14) of chemotherapy, to verify the inter-observer agreement, to compare the results of BMA and BMB, and to evaluate the impact of D14 blast clearance on the overall survival (OS).MethodsA total of 107 patients who received standard induction chemotherapy and had bone marrow samples were included. BMA evaluation was performed by two observers using two methods: quantitative assessment and a qualitative (Likert) scale. ROC curves were obtained correlating the BMA quantification of blasts and the qualitative scale, by both observers, with BMB result as gold-standard.ResultsThere was a significant agreement between the two observers in both the qualitative and quantitative assessments (Kw = 0.737, p < 0.001, and rs = 0.798, p < 0.001; ICC = 0.836, p < 0.001, respectively). The areas under the curve (AUC) were 0.924 and 0.946 for observer 1 and 0.867 and 0.870 for observer 2 for assessments of the percentage of blasts and qualitative scale, respectively. The best cutoff for blast percentage in BMA was 6 % and 7 % for observers 1 and 2, respectively. A similar analysis for the qualitative scale showed the best cutoff as “probably infiltrated”. Patients who attained higher grades of cytoreduction on D14 had better OS.ConclusionsEvaluation of D14 BMA using both methods had a significant agreement with BMB and between observers, identifying a population of patients with poor outcome.

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Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

Cited by 5 publications

References 30 publications

Acute myeloid leukemia: survival analysis of patients at a university hospital of Paraná

Acute myeloid leukemia: survival analysis of patients at a university hospital of Paraná

Perfil clínico-epidemiológico e sobrevida hospitalar dos casos de leucemia aguda em um hospital de referência em Rio Branco, Acre, 2007-2014

Evaluation of bone marrow aspirates in patients with acute myeloid leukemia at day 14 of induction therapy

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