Remission and survival rates of acute myeloid leukemia patients in Peshawar

ABSTRACT

Thirty four patients were diagnosed as having acute myeloid leukemia [AML] between July 1994 and June 1996 at Lady Reading Hospital, Peshawar. Aim of the study was to determine the remission rate, leukemia-free survival and overall survival of patients suffering from AML in the center. 20 [58%] patients were male while 14 [42%] patients were female. Median age was 30 years [range 5-59 years]. Twenty one [62%] of our patients were between the age of 17 and 36 years, thus more than half of our patients belonged to the younger age group. M1 and M2 sub-types were the most commonly encountered sub-types of AML in our patients. Minimum follow-up was for 12 months. All 34 evaluable patients received Cytarabine 100mg/m2 for 7 days and Daunorubicin 45 mg/m2 for 3 days [standard 7+3 regime]. Patients achieving a complete remission received four cycles of monthly Cytarabine 100mg/m2 for 5 days and Daunorubicin 45mg/m2 for 2 days [5+2 regime] as maintenance chemotherapy. Daunorubicin was replaced with 6-Thioguanine after 4 months of maintenance therapy. An overall response rate of 62% was achieved [complete remission in 50% patients and partial response in 12% patients]. Leukemia-free survival at 6 months and twelve months was 50% and 30% respectively. Our treatment strategies, results and difficulties involved in the treatment of acute myeloid leukemia patients in developing countries are discussed