A Prospective Study on the Clinical Course of Acute Myeloid Leukemia And Outcomes following the Induction Therapy
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 6
Abstract
Background: Acute myeloid leukemia (AML) is characterized by an increase in the number of myeloid cells in the marrow and an arrest in their maturation, frequently resulting in hematopoietic insufficiency (granulocytopenia, thrombocytopenia, or anemia), with or without leukocytosis. The aim of study is to identify the various modes of presentation and clinical course of different types of acute myeloid leukemia. Another aim is to study the outcomes of the induction therapy and its complications. Methods: Patients aged more than 12 years with acute myeloid leukemia constituted the study population. These patients were followed up for a period of 6 months after the induction phase. The patients were followed up with clinical evaluation and laboratory investigations during the induction therapy. The various complications arising during this period were carefully evaluated. At the end of induction, patients were evaluated clinically and with investigations including bone marrow examination to look for remission. The data were analyzed with the help of appropriate statistical methods. Results: Most patients had anemia (96.3%), thrombocytopenia (72%) and an ESR of more than 100mm in the 1st hour (65%). Abnormal peripheral smear is found in all patients and hence this may be a good screening test. AML-M2 (47%) was the commonest type in adults followed by AML-M1 and AML-M3. The induction chemotherapy resulted in a remission rate of 31.3% at the end of induction, the lower rate of remission could be due to increased incidence of infections because most of the patients were in the general ward and the overcrowding might have facilitated hospital-acquired infections. The induction death observed was 68.8% with sepsis being the leading causes of death. All deaths occurred in the first 3 weeks of induction. Infections are fairly common during induction and strict asepsis and meticulous measures are necessary to prevent infection. Patient characteristics such as the age, sex, socioeconomic status, lymphadenopathy, hepatosplenomegaly, and hemogram values did not show any prognostic significance. Conclusion: The comprehensive knowledge of the clinical presentation could be utilized for making out early diagnosis, which may be of help in treating acute myeloid leukemia and prognosticate the disease outcome.
Authors and Affiliations
P. C. Rajeev, Deepa Anirudhan
Keywords
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- EP ID EP548456
- DOI 10.21276/ijmrp.2017.3.6.011
- Views 94
- Downloads 0
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