2019, Number 1
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Rev Cubana Hematol Inmunol Hemoter 2019; 35 (1)
Incorporation of the high dose of anthracycline in the treatment of adult acute myeloid leukemia
Quintero SY, Hernández PC, Romero GA, Concepción FY, Macia PI, Llerena MD, Sarduy SS
Language: Spanish
References: 27
Page:
PDF size: 166.37 Kb.
ABSTRACT
Introduction: Acute myeloid leukemia represents 80% of acute leukemias among adults;
the induction treatment to obtain remission in patients under 60 years old is based on the
combination of anthracyclines and cytosine arabinoside.
Objective: To incorporate the high doses of anthracyclines to the treatment of induction
of non-promyelocytic acute myeloid leukemia in adult patients under 60 years of age.
Method: We conducted a quasi-experimental study in 41 patients with this diagnosis, at
the adult clinic service of the Institute of Hematology and Immunology, from september
2013 to december 2016. Morphological, immunological, cytogenetic and molecular studies
were carried out at the beginning of the disease and also echocardiography was performed
to determine the ejection fraction and shortening of the left ventricle a year after the end of
treatment, to determine cardiotoxicity due to the use of high doses of anthracyclines.
Results: The distribution by age was higher in the group of 46 to 52 years represented by
26.8% of the cases and the male sex predominated 60.9%. In 85% of the cases the
disease appeared de novo. According to the morphological criteria of the French American
British classification, 31.7% corresponded to the M1 variant, in close relation with the
determinations by flow cytometry, for this variety. The genes most commonly involved
were NPM1 and AML / ETO, for 24% and 22% respectively. 56.1% of patients achieved
hematological remission with a single treatment cycle and 14.6% of patients needed a
second induction scheme. No anthracycline cardiotoxicity events were reported during the
treatment, nor a year after the treatment, in the patients evaluated.
Conclusions: With the use of high doses of anthracycline, have been hematological
remissions, without demonstrated cardiovascular toxicity.
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