Acute Myeloid Leukaemia Clinical Trial
Official title:
Transfusion Dependency at Diagnosis and Transfusion Intensity During Initial Chemotherapy Are Associated With Poorer Outcomes in Adult Acute Myeloid Leukaemia
Acute myeloid leukaemia (AML) is a haematological malignant disease characterized by an
uncontrolled proliferation of immature hematopoietic cells. Over the last two decades,
clinical trials have demonstrated an improved response rate in younger adult AML. Aggressive
induction plus more potent intensification programs with chemotherapy alone or chemotherapy
plus stem cell transplantation (SCT) has improved treatment results. Advances in
understanding disease biology, improvements in induction and consolidation program, and
better supportive care have also all contributed. A number of clinical and laboratory
characteristics influence the response to treatment and, thus, the survival of patients with
AML. Among them, cytogenetic at diagnosis represents the most important prognostic variable.
However, other factors may have a prognostic value and may influence patient's outcome.
Anaemia and thrombocytopenia are cardinal manifestations of AML. Over the last decades, it
has become apparent that the frequency of allogeneic blood transfusions can modify host
immunity and clinical outcomes. Anaemia has long been recognized as an adverse prognostic
factor in myelodysplastic syndrome (MDS), which represents a pre-leukemic disease. Red blood
cell (RBC) transfusion need was identified as a strong and independent risk factor for
survival in MDS, for which the presence and severity of anaemia were attributed to a
clonally advanced and biologically more aggressive disease.
Based on these data, the investigators retrospectively assessed the prognostic value of RBC
and platelet transfusions at the time of diagnosis and the frequency of transfusions during
the first induction course of chemotherapy in a large unselected group of patients with
previously untreated AML.
n/a
Observational Model: Cohort, Time Perspective: Retrospective
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