Avaliação retrospectiva dos pacientes portadores de leucemia mielóide aguda tratados no Serviço de Hematologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre 1978 e 2007 / Retrospetive evaluation of acute myeloid leukemia patients treated in University of Sao Paulo General Hospital between 1978 and 2007

AUTOR(ES)

Murilo Chermont Azevedo

DATA DE PUBLICAÇÃO

2010

RESUMO

Acute myeloid leukemia in adults is still a highly fatal disease, except for acute promyelocitic leukemia. The optimization of treatment protocols has been debated for three decades, without satisfactory results. Prognostic factors like age, kariotype and consolidation with cytarabine in high dosis seem to correlact with a better overall survival. We conducted a retrospective study in the General Hospital of University of Sao Paulo analyzing medical records and acute myeloid leukemia outcomes to compare different treatment protocols used through 1978 to 2007. We also intended to validate international prognostic factors as the ones cited in our population. We analyzed 400 patients treated with curative intention and found better overall survival in 5 years regarding age less than 60 years (27% vs 7%), favorable karyotipe (53% vs 28% vs 5%) and high dosis cytarabine in consolidation, meanly if total dose was at least the median of 45,45 g (68% vs 44% vs 21%). Consolidation with high dosis cytarabine was an independent predictor of better overall survival. No estatistical differences were seen regarding myeloperoxidase positivity, induction protocol and FAB classification. We concluded that, if the induction protocols seem to be no different in results, consolidation with high dosis cytarabine for patients under 60 years has impact in overall survival, being even better when the total dosis is at least 45,45 g. Karyotipe has also been validated in our study population

ASSUNTO(S)

análise citogenética acute myeloid leukemia prognosis leucemia mielóide aguda cytogenetic analysis prognóstico survivor analysis cytarabine/therapeutic use citarabina/uso terapêutico análise de sobrevida

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