Treatment efficiency in patients with acute myeloid leukemia from 2019 to 2023 according to the Moscow Cancer Registry

Abstract

Aim. To evaluate the acute myeloid leukemia (AML) treatment efficacy in adults in Moscow real clinical practice according to the Moscow Cancer Registry data.Materials and methods. We retrospectively collected data from the Moscow Cancer Registry on Moscow permanent residents who were primary diagnosed with AML from January 2019 to November 2023. The effectiveness of antitumor therapy was assessed by the complete remissions rate, relapses, deaths, and 3-year overall and relapse-free survival. Data analysis performed as of 01.12.2023.Results. According to the Moscow Cancer Registry, from 01.01.2019 to 01.12.2023, the diagnosis of AML (except for acute promyelocytic leukemia) was established in 752 patients with a median age at the time of diagnosis of 64 (19– 94) years. In the studied sample, females slightly predominated: women – 56.6 % (n = 426), men – 43.4 % (n = 326). Of all patients included in the study, 36 % (n = 275) received intensive chemotherapy, while 57 % (n = 427) received low-intensity chemotherapy, and the remaining 7 % (n = 50) patients received best supportive care. Early mortality (first 60 days) in the total group was 16 % (n = 123), 20 % (n = 149) of patients were refractory to the therapy. Complete remission was achieved by 63 % (n = 473) of patients: 82 % (n = 225) of them received intensive chemotherapy, 58 % (n = 248) – low-intensity chemotherapy. Relapses occurred in 41 % (n = 194) of 473 patients who achieved complete remission. In the first remission, allogeneic hematopoietic stem cell transplantation was performed in 11 % (n = 79) of patients. With a median follow-up of 30.1 months, the 3-year overall survival in total group was 27 % (95 % confidence interval 23–32), and the 3-year relapse-free survival was 44 % (95 % confidence interval 37–51).Conclusion. The main problem in the treatment of adult AML patients remains high induction mortality and limited opportunities for allogeneic hematopoietic stem cell transplantation in real clinical practice, which emphasizes the need to develop transplant centers in Moscow.

Keywords

• acute myeloid leukemia
• efficacy of antitumor therapy
• targeted therapy
• allogeneic hematopoietic stem cell transplantation
• real clinical practice