Retrospective evaluation of acute myeloid leukemia cases

Aim: In this study, we aimed to retrospectively evaluate the demographic, clinical, laboratory, cytogenetic, molecular genetic and pathological characteristics of patients with AML in our center; to examine the effects of these characteristics on the treatment responses, prognosis, overall and disease-free survival rates of the patients and to contribute to the literature with the findings obtained. We also aimed to evaluate the overall survival of the patients by comparing the data in the database of Selçuk University Faculty of Medicine Hospital, a tertiary care hospital, with the literature. Patients and Method: We included 100 patients with AML who were followed up in our center between January 2016 and October 2024. Patient data were obtained retrospectively through the patient management information system. Findings: The study included 100 patients diagnosed with AML, with a mean age of 56.9 years; 54% were male. Among the cases, 89% were classified as de novo AML and 11% as secondary AML, with a significantly higher mean age observed in the secondary AML group. The majority of patients (63%) had at least one comorbidity. At diagnosis, anemia was present in 91%, thrombocytopenia in 90%, neutropenia in 49%, and leukopenia in 45% of patients. According to FAB classification, 13% of the patients were identified as APL, and none of the APL patients experienced relapse. Bone marrow reticulin fibrosis was detected in 47% of patients; however, fibrosis grades were not significantly associated with AML subtype, age, sex, or FAB classification. Among the 70 patients who received remission induction therapy, 78.6% achieved remission, including 100% of APL patients. Patients who achieved remission were significantly younger and had higher survival rates. The overall mean survival (OS) was 25.0 months, and disease-free survival (DFS) was 34.6 months. Survival analyses demonstrated that patients under 65 years had significantly longer OS and DFS compared to older patients. Gender had no significant impact on survival or treatment response. The relapse rate was 15%, and mortality was significantly higher among relapsed cases. Patients who underwent allogeneic stem cell transplantation were significantly younger than those who did not. Discussion and Conclusion: Although AML is a rare malignancy, it is an important disease due to its increasing incidence rate, high mortality and short survival. In the literature, it has been proven that the overall survival time varies significantly regionally, which emphasizes the importance of regional studies in AML. Despite the limitations of retrospective studies, our study provides a basic resource to better understand AML and guide future research.