What major factors affect disease progression and outcome in adults with acute myeloid leukemia?

This study examined the major factors associated with disease progression and outcomes in adults with acute myeloid leukemia (AML). The authors found that younger age, less molecular mutations and choice of induction therapy were all positively associated with higher rates of complete remission and survival.

A number of factors associated with AML may predict outcomes in patients. These can include genetic factors, age of the patient, overall health of the patient, and type of treatment. Response to induction (first) treatment also may predict outcome. However, more research is needed on the helpfulness of these factors as predictors.

This study included information on 137 adult AML patients. 64% of patients underwent 3+7 induction chemotherapy (3 days of anthracycline and 7 days of cytarabine). 20% received a hypermethylating agent (azacytidine or decitabine). 16% received only supportive care. 74% did not have a genetic mutation associated with AML.

Patients treated with 3+7 were younger, had a higher bone marrow blast percentage (number of immature white blood cells), and were more likely to have AML not caused by another syndrome. Older patients were more likely to have genetic mutations associated with AML.

Induction with 3+7 and absence of monosomy (a genetic abnormality where one member of a chromosome pair is missing) were associated with improved chances for complete remission (no sign of disease). Younger age and absence of monosomy were associated with the chance of improved overall survival (time from treatment until death from any cause). Other possible predictive factors were mutation status, other conditions, and time to complete response.

This study concluded that monosomy status and 3+7 induction treatment can predict improved remission rates, and monosomy status and younger age were predictors of survival.