Clinicohematological parameters and assessment of post induction status in acute myeloid leukemia–experience at a tertiary care center

Objective: To evaluate the role of clinical, hematological and genetic parameters in acute myeloid leukemia (AML) as the predictors of response to induction chemotherapy. Study Design: Cross-sectional study. Place and Duration of Study: Department of Haematology, Armed Forces Institute of Pathology, from Jun to Jun 2019. Methodology: All the newly diagnosed cases of de-novo AML were included in the study. Clinical, haematological and immunophenotypic parameters were noted. Cytogenetic and molecular analyses were performed. Response to first course of standard induction chemotherapy was assessed. Results: A total of 58 patients were included in the study. The median age was 19 years. Thirty-one (53.4%) were adults while 27 (46.6%) were in the pediatric age group. Thirty-six (62.1%) were males while 22 (37.9%) were females. The most common clinical presentation was fever. The most common French-American-British classification (FAB) subtype was AML-M2. The blast percentage was 78%. Forty-six (79.3%) patients had a normal karyotype. Of the 58 patients, 38 (65.5%) achieved complete remission while 20 (34.5%) did not achieve complete remission after induction chemotherapy. Conclusion: AML was seen in a younger age group in our population. There was statistically significant association of high white blood cell (WBC) count with remission status. Increasing age was associated with a poor response to induction chemotherapy, while translocation t(8;21) was associated with a good response. Assessment of prognostic parameters is vital in the initial diagnostic workup of AML patients to predict response to induction chemotherapy. (author)