title: Has the prognosis of adult patients with acute myeloid leukemia improved over years? A single institution experience of 784 consecutive patients over a 16-year period.
abstract: We reviewed the reports of 784 consecutive patients admitted to our department for newly diagnosed acute myeloid leukemia (AML) over a 16-year period. Median, 5-year and 10-year overall survivals were 9. 5 months, 17.3% and 11.7% respectively. Induction treatment (698 patients) resulted in 50% complete remissions (CR) (from 26.5% in secondary AML to 81.2% in patients <60 years with de novo AML). Period of diagnosis (1980-84/85-89/90-95) demonstrated a major significance for CR achievement and OS in multivariate analysis. In patients >/=60 years (372), CR rate increased (25% to 36.8%, P = 0. 03), and 5-year OS (3.7% to 10.6%, P = 0.022) improved, probably due to an increase in the proportion of patients administered conventional combined chemotherapy (54.5% to 83.8%, P < 0.0001). In younger patients CR rate continuously increased (61.5% to 74.8%, P = 0.028) with an associated improvement of 5-year OS (19.2% to 35.4%). No significant change in DFS and CR durations was observed. This large single center study on a large cohort of unselected AML patients reflects the improvement achieved in the management of AML patients, likely due to improvement of supportive care practices, administration of conventional induction to more elderly patients, and intensification of induction and post-remission treatments in patients <60 years.
authors.affiliation: Service d'Hématologie Clinique, Hôtel-Dieu, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Baudard
authors.forename: A
authors.initials: A
authors.lastname: Beauchamp-Nicoud
authors.forename: A
authors.initials: A
authors.lastname: Delmer
authors.forename: B
authors.initials: B
authors.lastname: Rio
authors.forename: C
authors.initials: C
authors.lastname: Blanc
authors.forename: R
authors.initials: R
authors.lastname: Zittoun
authors.forename: J P
authors.initials: JP
authors.lastname: Marie
mesh_terms: D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012074:Remission Induction / Q000379:methods*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents