Leukemia research · 2026
Intensive induction chemotherapy in adult acute myeloid leukemia: A single centre assessment of complete remission and induction mortality.
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Asghar Zoha, Saeed Nabiha, Shaikh Muhammad Usman
Аннотация
BACKGROUND: Acute myeloid leukemia (AML) is the most common acute leukemia in adults and is associated with substantial morbidity and mortality, particularly in lower- and middle-income countries. While intensive induction chemotherapy remains the standard of care, outcomes vary widely, and local data from Pakistan remain limited.
METHODS: We conducted a retrospective analysis of adults (≥18 years) with newly diagnosed AML treated with intensive induction chemotherapy at a tertiary care center from 2017 to 2023. Patients received either standard 3 + 7 or modified 2 + 5 induction. Primary outcomes were complete remission (CR) and induction mortality (death within 28 days of chemotherapy initiation). Secondary outcomes included overall survival (OS) and factors associated with CR and induction mortality.
RESULTS: A total of 110 patients were included (median age 35 years; 60.9% male). CR was achieved in 53.6% of patients, while induction mortality occurred in 20.9%, predominantly due to infections. Median follow-up was 12 months (95% CI: 9.04-14.96); estimated 2-year OS was 78.6%. In multivariable analysis, male gender, adverse cytogenetic risk, and FLT3-ITD mutation were associated with lower odds of achieving CR, while male gender significantly increased the risk of induction mortality.
CONCLUSION: Our findings highlight the need for risk-adapted treatment strategies and optimized supportive care to improve early outcomes in resource-constrained settings.
METHODS: We conducted a retrospective analysis of adults (≥18 years) with newly diagnosed AML treated with intensive induction chemotherapy at a tertiary care center from 2017 to 2023. Patients received either standard 3 + 7 or modified 2 + 5 induction. Primary outcomes were complete remission (CR) and induction mortality (death within 28 days of chemotherapy initiation). Secondary outcomes included overall survival (OS) and factors associated with CR and induction mortality.
RESULTS: A total of 110 patients were included (median age 35 years; 60.9% male). CR was achieved in 53.6% of patients, while induction mortality occurred in 20.9%, predominantly due to infections. Median follow-up was 12 months (95% CI: 9.04-14.96); estimated 2-year OS was 78.6%. In multivariable analysis, male gender, adverse cytogenetic risk, and FLT3-ITD mutation were associated with lower odds of achieving CR, while male gender significantly increased the risk of induction mortality.
CONCLUSION: Our findings highlight the need for risk-adapted treatment strategies and optimized supportive care to improve early outcomes in resource-constrained settings.