title: Acute myeloid leukaemia: challenges and real world data from India.
abstract: The management of acute myeloid leukaemia (AML) in India remains a challenge. In a two-year prospective study at our centre there were 380 newly diagnosed AML (excluding acute promyelocytic leukaemia, AML-M3) patients. The median age of newly diagnosed patients was 40 years (range: 1-79; 12.3% were ≤ 15 years, 16.3% were ≥ 60 years old) and there were 244 (64.2%) males. The median duration of symptoms prior to first presentation at our hospital was 4 weeks (range: 1-52). The median distance from home to hospital was 580 km (range: 6-3200 km). 109 (29%) opted for standard of care and were admitted for induction chemotherapy. Of the 271 that did not take treatment the major reason was lack of financial resources in 219 (81%). There were 27 (24.7%) inductions deaths and of these, 12 (44.5%) were due to multidrug-resistant gram-negative bacilli and 12 (44.5%) showed evidence of a fungal infection. The overall survival at 1 year was 70.4% ± 10.7%, 55.6% ± 6.8% and 42.4% ± 15.6% in patients aged ≤ 15 years, 15 - 60 years and ≥ 60 years, respectively. In conclusion, the biggest constraint is the cost of treatment and the absence of a health security net to treat all patients with this diagnosis.
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Chepsy
authors: C
authors: Philip
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Biju
authors: B
authors: George
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Abhijeet
authors: A
authors: Ganapule
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Anu
authors: A
authors: Korula
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Punit
authors: P
authors: Jain
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Ansu Abu
authors: AA
authors: Alex
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Kavitha M
authors: KM
authors: Lakshmi
authors: Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, India.
authors: Usha
authors: U
authors: Sitaram
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Fouzia N
authors: FN
authors: Abubacker
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Aby
authors: A
authors: Abraham
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Auro
authors: A
authors: Viswabandya
authors: Cytogenetics Unit, Christian Medical College, Vellore, India.
authors: Vivi M
authors: VM
authors: Srivastava
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Alok
authors: A
authors: Srivastava
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Poonkuzhali
authors: P
authors: Balasubramanian
authors: Department of Haematology, Christian Medical College, Vellore, India.
authors: Vikram
authors: V
authors: Mathews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
keywords: acute myeloid leukaemia; cost of therapy; induction mortality; multidrug-resistant bacteria; real world data