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Types,Clinical Features,and Survival Outcomes of Patients with Acute Myeloid Leukemia in Thailand: A 3-Year Prospective Multicenter Study from the Thai Acute Leukemia Study Group (TALSG)
Authors:Chinadol Wanitpongpun  Eakkapol Utchariyaprasit  Weerapat Owattanapanich  Adisak Tantiworawit  Ekarat Rattarittamrong  Pimjai Niparuck  Teeraya Puavilai  Jakrawadee Julamanee  Pirun Saelue  Chantiya Chanswangphuwana  Chantana Polprasert  Chajchawan Nakhakes  Wasithep Limvorapitak  Nonglak Kanitsap  Kannadit Prayongratana  Chantrapa Sriswasdi
Affiliation:1. Hematology Unit, Department of Internal Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand;2. Division of Hematology, Department of Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand;3. Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand;4. Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;5. Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand;6. Department of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand;7. Division of Hematology, Department of Medicine, Rajavithi Hospital, Bangkok, Thailand;8. Division of Hematology, Department of Internal Medicine, Thammasat University, Pathumthani, Thailand;9. Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Abstract:BackgroundAcute myeloid leukemia (AML) is a common, challenging hematologic malignancy worldwide. Thai data on its characteristics and outcomes have never been systematically reported, to our knowledge. The objective of this study was to determine the clinical features and outcomes of Thai patients with AML.Patients and MethodsThis was a prospective observational study of nine academic hospitals. Patients with newly diagnosed AML were invited to register online.ResultsA total of 679 patients with AML were included. The presence of circulating peripheral blood blasts was correlated with a high white blood cell count. Acute promyelocytic leukemia (APL) had predominantly lower white blood cell counts and higher proportions without peripheral blood blasts compared with non-APL AML. Disseminated intravascular coagulation was commonly presented in APL (37.7%). Splenomegaly and normal platelet count were more frequently seen in patients with Philadelphia chromosome–positive AML. The median follow-up time for those who survived more than 1 year was 28.0 months. One-year overall survival rates for non-APL AML and APL were 31.9% and 88.2%, respectively; 2-year overall survival rates were 29.6% and 88.2%, respectively. Hematopoietic stem cell transplantation could improve survival in non-APL AML.ConclusionAPL should be considered despite absence of peripheral blood blast. This study demonstrates poor outcome of Thai AML and more research to improve outcomes are underway. Expanding access to hematopoietic stem cell transplantation should be considered in Thailand.
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