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 National Institute of Blood and Marrow Transplant Rawalpindi (NIBMT/AFBMTC). 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.