ABSTRACT
BACKGROUND: Acute myeloid leukemia (AML) is the most common leukemia in adults. Aim: To Describe our population of patients with AML and report the outcomes of our treatments. MATERIAL AND METHODS: Review of electronic clinical records of 114 patients with AML with a median age of 57 years (59% men). Results: Seventeen percent of patients were classified as low risk, 38% as intermediate risk and 33% as high risk. Seventy-six percent of patients were treated with intensive chemotherapy. Five years overall survival according to cytogenetic risk was 59, 41, and 12% in low, intermediate, and high-risk patients, respectively. The outcomes were better in patients under 60 years. The median survival of patients treated with intensive chemotherapy aged less than 60 years and 60 years and above was 3.4 and 1 year, respectively. CONCLUSIONS: Our results are comparable to those reported in developed countries. Improving the survival of patients 60 years and older is our main challenge.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Leukemia, Myelomonocytic, Acute/genetics , Leukemia, Myelomonocytic, Acute/drug therapy , Retrospective Studies , Treatment OutcomeABSTRACT
We describe the management and follow-up of a 20-year-old male with acute myeloblastic leukemia with translocation (8; 21) [t (8; 21)]. A quantitative polymerase chain reaction for t(8; 21) in bone marrow was performed at diagnosis and after three consolidations with high doses of cytarabine. Currently, the management of this type of leukemias has been oriented towards the early detection of relapse. The concept of minimal or measurable residual disease, as the burden of leukemia cells that persist undetected, is an important tool in the therapeutic decision and follow-up of these patients.
Subject(s)
Humans , Male , Adult , Young Adult , Leukemia, Myelomonocytic, Acute/drug therapy , Leukemia, Myeloid, Acute/genetics , Translocation, Genetic , Bone Marrow , Follow-Up Studies , Neoplasm, ResidualSubject(s)
Antigens, CD7/metabolism , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chromosomes, Human, Pair 21/genetics , Down Syndrome/genetics , Female , Humans , Immunophenotyping , In Situ Hybridization, Fluorescence , Leukemia, Myelomonocytic, Acute/drug therapy , Middle Aged , Neprilysin/metabolismSubject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Diabetes Mellitus, Type 1/chemically induced , Female , Granulocyte-Macrophage Colony-Stimulating Factor/adverse effects , Humans , Hyperglycemia/chemically induced , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myelomonocytic, Acute/drug therapy , Middle AgedABSTRACT
O diagnóstico de leucemia aguda na gestäo é pouco comum e possui particularidades próprias relacionadas, principalmente, ao manejo. A gestäo em si parece näo alterar a história natural da doença, nem a resposta ao tratamento. Sua maior implicaçäo reside nos riscos da exposiçäo fetal aos agentes quimioterápicos, bem como as complicaçöes maternas relacionadas à própria doença e tratamento. Os efeitos tóxicos do quimioterápicos säo potencialmente prejudiciais ao feto durante o período da embriogênese. Complicaçöes maternas relacionadas ao tratamento podem alterar o desenvolvimento fetal. Este trabalho realiza uma revisäo da literatura existente sobre leucemia e gestaçäo e relata a evoluçäo de 4 pacientes gestantes com diagnóstcio de leucemia aguda, atendidas no Serviço de Hematologia do Hospital de Clínicas de Porto Alegre (HCPA), entre 1990 - 1994. Em três casos o diagnóstico foi de leucemia linfocítica aguda (LLA) e em um de leucemia mielocitica aguda (LMA). O tratamento de induçäo foi realizado com quimioterapia intensiva, obtendo-se a remissäo em todos os casos. Três gestaçöes evoluíram com morte fetal e uma foi interrompida com cesareana. Todas as pacientes apresentaram algum tipo de complicaçäo (anemia, infecçäo) relacionada ao tratamento. A série apresentada é restrita pelo pequeno número de pacientes, assim, seus resultados näo säo conclusivos. A criaçäo de um registro geral destes casos poderia aumentar a casuística e as informaçöes referentes ao tratamento, evoluçäo e efeitos dos quimioterápicos sobre o feto