Characteristics and results of treatment of younger patients less than 60 years old with AML: analysis of real data from the Czech DATOOL-AML database
Abstract
The aim of this work was to analyse retrospectively real clinical data from AML patients aged 18-60 years diagnosed and treated over the past 13 years in one of the six haemato-oncology centres in the Czech Republic that form the collaborative CELL group. Data from these centres was compared with the survival results of patients treated in clinical trials and data from renowned institutions abroad.
The DATOOL-AML database was used as a source of this data. A total of 940 patients aged 18-60 years were diagnosed and treated for de novo AML in the CELL group centres between 2007 and 2018.
Based on cytogenetic and molecular genetic results, it was possible to determine some type of known genetically defined prognostic marker in 66% of patients. An intensive therapeutic approach was initiated in 93.6% of patients (N=788), of which 93.4% (N=736) received the "3+7" induction regimen as first line therapy.
Complete remission after induction therapy was achieved in 72% of patients. The risk of early death during induction chemotherapy was 4%.
Allogeneic haematopoietic stem cell transplantation (HSCT) was performed in first remission in 53.8% with intermediate-I risk; 57.3% of patients with intermediate-II risk and 49.3% of patients with high risk. Allogeneic HSCT in first complete remission led to significant prolongation of overall survival in patients with normal karyotype and concurrent FLT3-ITD+/NPM1-, as well as in patients with intermediate risk and complex karyotype.
The median survival of all patients in our sample was 26.5 months and 39.2% were alive five years from diagnosis. The results of care for younger AML patients in Czech haemato-oncology centres correspond to those of large clinical trials as well as renowned international institutions.
It is the authors' view that despite all the limitations of such a comparison this is to a certain extent due to centralisation of such type of care in the Czech Republic in highly specialised centres.