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Abstract
We evaluated the prognostic factors affecting the induction therapy of newly diagnosed AML patients in NCI-Egypt between January 2004 and December 2005. The evaluation included the age, the clinical presentation at diagnosis, the initial hemogram (TLC, hemoglobin and platelets), renal functions, hepatic functions, initial BMA, immunophenotyping, cytogenetics and BMA at D14.
We found that 54.5% of the patients died early in the course of treatment. The significant factors affected the early death were the high TLC count (p: 0.057) and low albumin level at presentation (p: 0.66).
We found that the following factors inversely affected the prognosis of the induction therapy; the age of the patients older than 45 years (P: 0.018), the high total leucocytic count (≥ 100 x 109/L and ≥ 25 x 109/L) (P: < 0. 001) and the low level of albumin (≤ 3gm/l) (p: 0.041).
The early blast clearance by remission induction therapy evident by D14 BMA was good prognostic factor (P =0.001). The presence of MPO was a marginally adverse prognostic factor in the CR rate (p: 0.055) and finally the cytogenetics at diagnosis is a significant prognostic variable affecting the CR rate (P: 0.022).