Acute Myeloid Leukemia; Experience at a Resource Limited Health Care Facility of Pakistan

Abstract

Objective: To determine the demographics and the clinical outcome of Acute Myeloid leukemia at a resource limited setting.

Methodology: A retrospective study at the Department of Medical Oncology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2005 to April 2022 was conducted. Total 334 patients of AML were reviewed for age, gender, address, HBV/HCV status, peripheral film, bone marrow biopsy, flow cytometry, gene markers, cytogenetics, treatment and outcome.

Results:  AML was predominant in adults with a median age of 30, 193(57.8%) in the age group of (19-40 years) followed by 67(20.1%) in the age group of (12-18y), 58(17.4%) in (41-60y) and 16(4.8%) in elderly patients above 60 years of age. Males were affected more compared to females 191(57.2%) vs 143(42.8%). Patients from Punjab accounted for 150(44.7%) of all the cases, followed by AJK 75(22.5%) and KPK 68(20.4%). Among all 334 patients, 32(9.6%) had white blood cells above 100,000 and 252(75.4%) had more than 20% blasts in peripheral film. Out of 334 patients, 260 (77.8%) patients were diagnosed as AML, 72 (21.6%) as APML and 2 (0.6%) as MPD transformed to AML. All patients received remission induction chemotherapy, 93 patients died during induction resulting in treatment related mortality (TRM) of 27.3%.

Conclusion: Acute myeloid leukemia in Pakistani population is seen in relatively younger age group with male predominance.