title: De novo acute myeloid leukemia in adults younger than 60 years of age: socioeconomic aspects and treatment results in a Brazilian university center.
abstract: We retrospectively studied the outcomes of adults with de novo acute myeloid leukemia treated in a reference center in Brazil and analyzed the association with the human development index (HDI) of the United Nations used as a socioeconomic factor. Among 123 patients, 46 (37%) died during induction, 65 (53%) reached complete remission and 45 (37%) received high-dose cytarabine (Hidac) consolidation. The 5-year overall survival and leukemia-free survival (LFS) were 17 and 26%, respectively, for all patients and 36 and 30%, respectively, for those receiving Hidac. In multivariate analysis, an HDI <0.660 was associated with a lower probability to receive Hidac (P = 0.001), a trend for higher mortality in remission induction (P = 0.062) and a decreased LFS (P < 0.0001). However, it was not associated with outcomes for patients receiving Hidac. In conclusion, survival for patients who received Hidac consolidation is satisfactory; however, socioeconomic factors may have selected patients to receive intensive Hidac consolidation.
authors.affiliation: Hematology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil. fagundes@hematologica.com.br
authors.forename: Evandro M
authors.initials: EM
authors.lastname: Fagundes
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: Ana Beatriz F
authors.initials: AB
authors.lastname: Glória
authors.forename: Nelma Cristina D
authors.initials: NC
authors.lastname: Clementino
authors.forename: José S
authors.initials: JS
authors.lastname: Quintão
authors.forename: João Paulo O
authors.initials: JP
authors.lastname: Guimarães
authors.forename: Enio Roberto P
authors.initials: ER
authors.lastname: Pedroso
authors.forename: Marcos B
authors.initials: MB
authors.lastname: Viana
mesh_terms: D000046:Academic Medical Centers; D000208:Acute Disease; D001938:Brazil / Q000453:epidemiology; D003561:Cytarabine / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D018579:Patient Selection; D012074:Remission Induction; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate
chemical_list: D003561:Cytarabine