The effect of induction chemotherapy on leukemia-related anemia in acute myeloid leukemia patients

Cinar, OE. The Effect of Induction Chemotherapy on Leukemia-related Anemia in Acute Myeloid Leukemia Patients. Hacettepe University Faculty of Medicine, Department of Internal Medicine, Thesis in Internal Medicine Specialty, Ankara - Turkey 2018. Objective: To investigate the serum hemoglobin levels of AML patients who divided into three different AML subtypes and underwent different treatment approaches. Materials and Methods: A total of 276 AML patients who were administered different treatment approaches at the Hacettepe Hematology Department between Jan 2002 and May 2018 were retrospectively examined. The patients were divided into four groups: intensive treatment achieving complete remission (CR), intensive treatment without CR, non-intensive treatment and supportive treatment. Results: The mean hemoglobin levels at the time of diagnosis were 8.5 g / dL(6.4 – 14.4,  1.7). There was no significant difference between the groups according to the AML types in terms of hemoglobin levels at the time of diagnosis but the Hb value was lower in the secondary AML subgroup (p = 0.082). Hb values after induction chemotherapy were significantly different between treatment groups (p <0.001). When the variables affecting the state of complete remission are examined by logistic regression; per 1 gr/dL increase Hb level at the time of diagnosis increased the probability of remission significantly (p = 0.047, OR = 1.13, 95% CI 1.07 - 1.24). Conclusion: Chemotherapy improves anemia in patients with AML after a short-term period of aplasia concomitant with the achievement of CR,which is considered to be a sign of the removal of the suppressive effects of neoplasia on hematopoiesis. As the anemia of AML patients deepens at the time of diagnosis, the likelihood of remission after treatment is reduced. Keywords: Acute myeloid leukemia, induction chemotherapy, leukemia-related anemia