Clinical Profile of Acute Myeloid Leukemia in North India and Utility of Nontransplant Measures in its Management

Abstract

Introduction: Acute myeloid leukemia (AML) is a clonal accumulation of myeloid precursors in body tissues, which ultimately leads to bone marrow failure. This is an 8-year prospective, observational study in which 254 patients were enrolled. Aim of the Study: To document the clinical profile of AML and differential outcome in M3 versus non-M3 phenotype and to see impact of different variables on its survival. Methods: Patients enrolled in the study were examined, evaluated, and given standard 3:7 induction protocol, and acute promyelocytic leukemia (APML) patients were given the ICAPL 2006 protocol. Results: In our study, males outnumbered females and most of our patients were in 20-60 years of age group. The better prognosis was in patients who were in the second decade of life. Total leukocyte count and platelet count had a significant impact on the survival of the a patient. Bone marrow morphology of M3 type has extremely good prognosis and was the most common FAB type seen in our study. Flow cytometric markers such as CD15, CD33, CD117, and myeloperoxidase had positivity among 90% of patients. Overall survival is around 40% in whole-study group, 87% in APML group, and 16.5% in non-M3 group. There are still unmet needs in managing the non-M3 patients in resource-constraint countries where allogenic transplant and newer drugs have the least access. For improving the outcome in M3 AML, further newer molecules such as Flt3 and PIK3 inhibitors are being used in trials. Conclusion: There are still unmet needs in managing the non-M3 patients in resource-constraint countries where allogenic transplant and newer drugs have the least access. For improving the outcome in M3 AML, further newer molecules such as Flt3 and PIK3 inhibitors are being used in trials.

Evaluation of Acute Leukaemias by Flow Cytometry and Its Correlation With Diagnosis Using Morphological and Special Staining Techniques

“…There is an obvious male preponderance (35 cases; 61.4%) against 22 cases (38.6%) in the present study. The gender distribution in most of the reported studies by Parekh [23], Bansal et al [24], Liu et al [25], and Shoket et al [26] have a male preponderance, tallying with the present findings.…”

“…It is important to diagnose ALL L3 if the mature B-cells lack CD34 expression. Additional evidence, such as TdT negativity, must also support the diagnosis [26][27][28][29]. According to research by Basso et al [30], immature hematopoietic cells generally express CD34.…”

Luaran Hasil Leukemia Mieloid Akut yang Menjalani Terapi pada Ruang Kemoterapi Semi-Isolasi

“…2 Faktor herediter, radiasi, kimia, paparan lingkungan kerja, dan obat-obatan tertentu berperan dalam terjadinya LMA. 1,3 Usia rata-rata kejadian LMA adalah 67 tahun, namun studi-studi terbaru menunjukkan insiden terbanyak dimulai dari 50 tahun. 1,2 Terdapat beberapa faktor yang dapat memprediksi luaran dari pasien-pasien LMA, yaitu usia saat diagnosis, presentasi nilai leukosit yang tinggi, dan profil sitogenetik.…”

“…1,2 Terdapat beberapa faktor yang dapat memprediksi luaran dari pasien-pasien LMA, yaitu usia saat diagnosis, presentasi nilai leukosit yang tinggi, dan profil sitogenetik. [1][2][3] Sebuah studi metaanalisis mengevaluasi tindakan isolasi protektif pada pasien-pasien keganasan hematologi. Hasil studi tersebut menunjukkan pengurangan dari seluruh penyebab kematian dan infeksi berkaitan dengan penggunaan profilaksis antimikrobial-antifungal yang dikombinasikan dengan kontrol kualitas udara dan perlindungan ruang isolasi.…”