[Long-term treatment and prognostic factors in adult acute myeloblastic leukemia. Experience of the INNSZ group Puebla-Monterrey-Mexico)].
The results of the treatment in a group of 43 adult patients with acute myelogenous leukemia (AML) are analyzed. All patients were induced to remission with a 7/3 schedule: cytarabine in continuous infusion during seven days and an anthracycline in push during three days; consolidation was done with the same regimen and no maintenance therapy was used. Complete remission (CR) was achieved in 60%, median survival of those achieving CR was 21 months. Mortality during induction was 30%; relapses occurred in 61% of those achieving CR. Twelve and 78 months overall-survival was 50 and 18% respectively, whereas 12 and 78 months disease-free-survival was 46 and 16% respectively. Fourteen variables were analyzed in their impact in both CR achievement and long term survival. Four variables were found to be associated with CR achievement: hemoglobin levels, major bleeding and infection at diagnosis, and site of treatment (private practice vs city hospital). All variables were associated with the 78 months survival, but two variables were related to 12 months survival: time of recovery of the bone marrow after ablative chemotherapy and amount of platelets transfused during the chemotherapy-induced hypoplasia. With regard to the first variable, the 12 months survival was 90 and 55% for patients recovering a normal bone marrow, before or after 25 days of initiation of chemotherapy (p less than 0.05). On the other hand, the hemorrhage-associated-mortality during induction was 9 and 36% for patients receiving more or less than 20 units of platelets during hypoplasia respectively (p = 0.038).(ABSTRACT TRUNCATED AT 250 WORDS)
Lobato-Mendizabal
E
E
Hospital Universitario de Puebla, México.
Ruiz-Argüelles
G J
GJ
Gómez-Almaguer
D
D
Ganci-Cerrud
G
G
Lozano de la Vega
A
A
Labardini-Méndez
J
J
D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced / Q000150:complications; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D003906:Developing Countries; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D007239:Infections / Q000209:etiology / Q000401:mortality; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D008297:Male; D008800:Mexico; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications
D003561:Cytarabine; D015251:Epirubicin; D004317:Doxorubicin; D008942:Mitoxantrone; D003630:Daunorubicin
Tratamiento a largo plazo y factores pronósticos en leucemia aguda mieloblástica del adulto. Experiencia del grupo INNSZ (Puebla-Monterrey-México).