Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION: Outcomes in older adult patients with non-M3 acute myeloid leukemia
(AML) have generally been poor. This study presents the first survival analysis of elderly patients
with non-M3 AML at a tertiary care hospital in Quito, Ecuador.
OBJECTIVES: To describe the overall survival (OS) of patients ≥ 65 years diagnosed with AML
between January 2012 and December 2019 (pre-COVID-19 pandemic period).
MATERIALS AND METHODS:
A retrospective review was conducted of medical records
from patients ≥ 65 years diagnosed with non-M3 AML between 2012 and 2019, followed up until December 2021. A survival analysis was performed and its relationship with clinical and demographic variables.
RESULTS: A total of 100 patients were included, with a median age of 74 years. Of these, 77
patients (77%) had de novo AML, and 23 (23%) had secondary AML. Forty (40%) patients received
intensive chemotherapy (IC); 34 (34%) patients received low-dose ARA-C, and 17 (17%)
received supportive care only. The overall survival at 1 year for all patients was 16%; median
survival was 5 months in the intensive chemotherapy group, 3 months in the low-dose ARA-C
group, 1 month in the supportive care only group, 3 months in the secondary AML group, and 3
months in the de novo AML group. A leukocyte count ≥ 40,000/mm3 at diagnosis was negatively
associated with OS (HR 2.81 [95% CI 1.60-4.02], p < 0.01), while receiving intensive chemotherapy
was positively associated with OS (HR 0.35 [95% CI 0.19-1.63], p < 0.01).
CONCLUSIONS: The poor outcomes in these patients are lower than those reported in other real-world studies with conventional reatments. In our setting, improving survival in elderly AML patients could be related to improvements in patient support and care.
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