title: [Clinical and epidemiological characteristics of acute myeloid leukemias in adults according to the data of municipal hematology departments in Moscow].
abstract: OBJECTIVE
  To estimate the incidence of acute myeloid leukemias (AML) in Moscow adults and to evaluate the efficiency of their treatment.
  
  
  METHODS
  Data on Moscow residents who were first diagnosed with AML in 2010 were retrospectively collected. The efficiency of their treatment was evaluated from the rates of complete remissions (CR), recurrences, deaths, and 4-year overall (OS) and relapse-free survival (RFS). The data as of September 1, 2013, were analyzed.
  
  
  RESULTS
  According to the 2010 pooled materials of the city's municipal hematology departments, AML (non-M3 types) was diagnosed in 286 patients whose median age at diagnosis was 64.9 years (range, 18.2-92.0 years). The notified incidence rate was 2.9 (3.3 for men and 2.6 for women) cases per 100,000 population. 118 (41%) patients received intensive chemotherapy (ICT); 119 (42%) had chemotherapy with low-dose cytarabine (LDC); 7 (2%) had that with hypomethylating agents (HA); and 42 (15%) had palliative therapy (PT). During first-line therapy, none of the patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the entire group, the early (within the first 60 days) mortality rates were 42% (119 deaths); that of patients with primary refractory disease was 32% (90 deaths). CR was achieved in 77 (27%) patients: 57 (48%) on ICT, 17 (14%) on LDC, and 3 (43%) on HA. Recurrences occurred in 37 (48%) of the 77 patients who had achieved CR at a median follow-up of 43.9 months. Four-year OS in all the patients receiving PT was 9.8±1.9% (18.2±3.9% in the patients on ICT versus 4.5±2% in those of LDC; p=0.028); 4-year RFS was 36.1±5.7% (39.6±6.7% inthe patients on ICT versus 31.3±11 .6% in those on LDC; p=0.8).
  
  
  CONCLUSIONS
  High mortality rates in the induction, which are caused by the limited resources of accompanying therapy, poor sanitary conditions, and no own opportunities to perform allo-HSCT, remain a key problem of AML therapy in adults.
authors.affiliation: Dmitry Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia; Department of Pediatric Oncology, Hematology, and Radiation Therapy, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: S V
authors.initials: SV
authors.lastname: Semochkin
authors.affiliation: Dmitry Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: T N
authors.initials: TN
authors.lastname: Tolstykh
authors.affiliation: City Clinical Hospital Forty, Moscow, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Arkhipova
authors.affiliation: S.P. Botkin City Clinical Hospital, Moscow, Russia.
authors.forename: V L
authors.initials: VL
authors.lastname: Ivanova
authors.affiliation: City Clinical Hospital Eighty-One, Moscow, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Klyueva
authors.affiliation: S.P. Botkin City Clinical Hospital, Moscow, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Lunin
authors.affiliation: City Clinical Hospital Fifty-Two, Moscow, Russia.
authors.forename: E N
authors.initials: EN
authors.lastname: Misyurina
authors.affiliation: Moscow Clinical Research Centre, Moscow Healthcare Department, Moscow, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Tumanova
authors.affiliation: S.P. Botkin City Clinical Hospital, Moscow, Russia.
authors.forename: N K
authors.initials: NK
authors.lastname: Khuazheva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009031:Moscow / Q000453:epidemiology; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult