Akut Miyeloid Lösemi Hastalarında İlk Basamak Tedavide Tam Remisyon Hedefi Olan Rejimlerin Karşılaştırılması

Abstract

Acute Myeloid Leukemia (AML) is characterized as a heterogeneous disease in which there is a clonal increase in myeloid progenitor cells (blasts) in the bone marrow and peripheral blood. The objective of this study is to compare the efficacy, safety, and side effects of regimens administered with the goal of achieving complete remission in patients with Acute Myeloid Leukemia. This study evaluated the data of 130 patients selected based on inclusion and exclusion criteria. Inclusion criteria consisted of being over 18 years old (adult), having a diagnosis of non-APL AML, and initiating the first course of chemotherapy treatment at our institution. Induction treatment resulted in a significant increase in hemoglobin levels (p<0.001), neutrophil count (p<0.001), and platelet count (p<0.001) in patients.It was demonstrated that lower fibrinogen levels (p=0.047) or ferritin levels (p=0.01) at the time of diagnosis were associated with achieving remission. In our study, the average albumin level at diagnosis for patients who achieved remission with the first course of chemotherapy was 3.91±0.46 g/dl, whereas it was significantly higher compared to patients who did not achieve remission (3.73±0.48 g/dl, p=0.048).In this study, it was observed that there was no superiority among intensive anthracycline + cytarabine (3+7), reduced-intensity anthracycline + cytarabine, etoposide + cytarabine, and azacitidine + venetoclax regimens in terms of achieving remission. However, the complication rates varied, suggesting that when deciding on the optimal induction treatment, the focus should be on minimizing complications rather than effectiveness, taking into account the patient's performance, age, and comorbidities. This approach may lead to the lowest morbidity and mortality rates achievable.