Induction mortality and remission rate after 1st cycle of standard 7+3 regimen chemotherapy in patients of acute myeloid leukemia.

Abstract

Objective: To determine the remission rate, mortality rate, and induction failure after standard 7+3 induction chemotherapy in patients with AML in Pakistan. Study Design: This study utilized a descriptive design. Setting: The study was conducted at the Armed Forces Bone Marrow Transplant Centre Rawalpindi. Period: August 2018 to May 2021. Methods: The study cohort comprised 88 patients aged 15 to 55 years, inclusive of both genders, diagnosed with acute myeloid leukemia (AML). All participants received standard induction chemotherapy. Remission status was evaluated either upon hematologic recovery or on Day 42 of treatment, whichever occurred first. Patients who died prior to initiating induction chemotherapy or discontinued hospitalization before completing the induction course were excluded from the analysis. Written informed consent was obtained from each enrolled patient. Results: A total of 88 patients were enrolled, with a mean age of 29.18±10.6 years. Sixty-one percent of the patients were 30 years or younger, while the remaining 38.6% were aged between 31 and 55 years. Among the patients, 50 (57%) were male and 38 (43%) were female, resulting in a male-to-female ratio of 1:1.3. The mean blast percentage in the diagnostic bone marrow was 75±21.9%. The majority of patients belonged to the AML M2 subtype (50%), followed by AML M4 (15.9%), AML M1 (13.6%), and AML M0, M5, and AML-MRC (6.8% each). Remission was achieved in 71.6% of the total patients, while 4.5% were not assessed for remission due to death, and 23.9% were refractory to the first cycle of chemotherapy. The frequency of induction mortality in our study was 4.5%. Conclusion: The 7+3 regimen is an effective intensive induction chemotherapy for fit patients to achieve remission with an acceptable treatment-related mortality rate.