Acute Myeloid Leukemia: analysis of epidemiological profile and survival rate

ObjectiveTo describe the epidemiological profile and the survival rate of patients with acute myeloid leukemia (AML) in a state reference pediatric hospital.MethodClinical‐epidemiological, observational, retrospective, descriptive study. The study included new cases of patients with AML, diagnosed between 2004 and 2012, younger than 15 years.ResultsOf the 51 patients studied, 84% were white; 45% were females and 55%, males. Regarding age, 8% were younger than 1 year, 47% were aged between 1 and 10 years, and 45% were older than 10 years. The main signs/symptoms were fever (41.1%), asthenia/lack of appetite (35.2%), and hemorrhagic manifestations (27.4%). The most affected extra‐medullary site was the central nervous system (14%). In 47% of patients, the white blood cell (WBC) count was below 10,000/mm3 at diagnosis. The minimal residual disease (MRD) was less than 0.1%, on the 15th day of treatment in 16% of the sample. Medullary relapse occurred in 14% of cases. When comparing the bone marrow MRD with the vital status, it was observed that 71.42% of the patients with type M3 AML were alive, as were 54.05% of those with non‐M3 AML. The death rate was 43% and the main proximate cause was septic shock (63.6%).ConclusionsIn this study, the majority of patients were male, white, and older than 1 year. Most patients with WBC count < 10,000/mm3 at diagnosis lived. Overall survival was higher in patients with MRD < 0.1%. The prognosis was better in patients with AML‐M3.

ResumoObjetivoDescrever o perfil epidemiológico e a taxa de sobrevida dos pacientes com leucemia mielóide aguda (LMA) em um hospital pediátrico de referência estadual.MétodoEstudo clínico‐epidemiológico, observacional, retrospectivo e descritivo. Foram incluídos casos novos de pacientes com LMA, diagnosticados entre 2004 e 2012, com idade < 15 anos.ResultadosEntre os 51 pacientes estudados, 84% eram da etnia branca, 45% do sexo feminino e 55% do masculino. Quanto à faixa etária, 8% tinham  < 1 ano, 47% entre 1 e 10 anos e 45% > 10 anos. Os principais sinais/sintomas ao diagnóstico foram febre (41,1%), astenia/inapetência (35,2%) e manifestações hemorrágicas (27,4%). O sistema nervoso central foi o local extramedular mais acometido (14%). Em 47% dos pacientes a leucometria ao diagnóstico foi < 10.000/mm3. A doença residual mínima (DRM) no 15° dia de tratamento foi < 0,1% em 16% da casuística. Recidiva medular ocorreu em 14% dos casos. Ao se comparar a DRM da medula óssea com o status vital, observou‐se que estavam vivos 71,42% dos pacientes com LMA tipo M3 e 54,05% daqueles com LMA não M3. A taxa de óbito foi de 43% e a principal causa imediata foi o choque séptico (63,6%).ConclusõesNeste estudo, a maioria dos pacientes é do sexo masculino, etnia branca, maiores do que um ano. A maioria dos pacientes com leucometria < 10.000/mm3 ao diagnóstico está viva. A sobrevida global é maior nos pacientes com DRM < 0,1%. O prognóstico é melhor nos pacientes com LMA‐M3.