Comparison of outcomes and prognostic factors for two groups of patients with acute myeloblastic leukemia

Outcomes of the “practice” of groups of physicians working over two consecutive time intervals at the Princess Margaret Hospital have been compared. During the first interval (1970–1974), a remission induction regimen of cyclophosphamide, cytosine arabinoside and vincristine was used. During the second (1974–1976), the regimen consisted of adriamycin and cytosine arabinoside. The results of the analysis indicated that although the prognostic factors for the groups of patients differed slightly during the two study periods, the frequency of response to treatment and the survival curves for the two groups did not differ significantly. However, the quality of survival, as assessed by time spent in hospital, was significantly improved in the second interval.

The major prognostic factors studied (age, platelet count and percentage of marrow blasts) appeared to be associated mainly with survival times less than the median, and to be predictive for a subgroup of patients with a poor prognosis, unlikely to achieve remission. These studies illustrate the need for ways to identify and salvage such high-risk patients.