Acute myeloid leukemia in the adult. Results of the National Antineoplastic Drug Protocol (Panda) at the Hospital del Salvador, Chile

Background: The incidence of acute myeloid leukemia is 3 cases per 100,000 inhabitants/year and its five years event free survival is 15 to 20%. Since the incorporation of trans retinoic acid, event free survival of M3 acute myeloid leukemia is 80%. Aim: To report and result of acute myeloid leukemi a treatment at the Hospital del Salvador, between 1990 and 1998. Patients a nd methods: The medical records of 117 patients (66 female, mean age 48.2 y ears), treated between 1990 and 1998 using PANDA protocol, were retrospecti vely reviewed. Immunophenotyping was done in 69 patients and cytogenetic st udies were retrospectively reviewed. Immunophenotyping was done in 69 patie nts and cytogenetic studies were done in 65. Results: Sixteen percent of pa tients had M3 acute myeloid leukemia. The most frequent phenotype was the a ssociation of DR, CD34 plus a panmyeloid marker. DR and CD34 were negative in seven of nine patients with M3 acute myeloid leukemia. Cariotype was abn ormal in 78% of patients. Complete remission was achieved in 65% of cases w ith a 13% of failures. Early mortality was 21.3% and decreased to 6.1% in t he last three years. Infections and coagulation disorders were the main cau ses of death. Mean survival was 10.5 months. Five years event free survival was 11%. In M3 acute myeloid leukemia, the figure is 50%. Conclusions: Tre atment results are less effective than protocols that consider more aggress ive chemotherapeutic protocols or bone marrow transplantation. The reductio n in early mortality is due to a better management of febrile neutropenia.