Frequency of complete remission after standard 3+7 induction therapy in patients with acute myeloid leukemia

Pak J Med Sci. 2022 May-Jun;38(5):1138-1142. doi: 10.12669/pjms.38.5.5249.

Abstract

Objectives: To find the frequency of complete remission rate after standard 3+7 induction therapy in patients with Acute Myeloid Leukemia (AML) among different clinicopathological groups.

Methods: Non-probability purposive sampling technique was used to collect data from July 2016 to Jan 2017, conducted at Department of Oncology, Jinnah Hospital Lahore. Sample size of 50 cases was calculated with 95% confidence level, 14% margin of error and taking expected percentage of complete remission (CR) 57% in AML patients after 3+7 induction therapy.

Results: Out of 46 patients, majority had AML-M2. AML- Not Otherwise Specified (NOS) disease. Most common pathological presentation was Total Leucocyte Count (TLC) of <50,000/mm3 (60%) as compared to patients with hyperleukocytosis i.e., TLC >50,000/mm3 (40%). Twenty-two percent had low Lactate Dehydrogenase (LDH) level involvement and 78% had high LDH level involvement. As compared to target of 57 %, complete response was observed in 54% patients, (p<0.02) with better results in younger age group, male patients with low LDH and TLC level.

Conclusion: It was concluded that 3+7 induction chemotherapy has 54% CR rates in patients with AML. Whereas, in AML-M5, AML-M6, AML-NOS patients especially, with high LDH and TLC and patients with advanced age, CR rate is low and needs more aggressive treatment.

Keywords: Acute Myeloid Leukemia; Complete Remission; Induction Chemotherapy; LDH; TLC.