Neeraj, S (2010) Clinical Profile of Young Adult Patients with Acute Myeloid Leukemia: Impact of Molecular Markers and Leukemic Stem Cells on Clinical Outcomes. Masters thesis, Christian Medical College, Vellore.
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Abstract
Although the cytogenetic status of patients with AML is considered the single most important prognostic factor at diagnosis, additional markers are evolving which in conjunction with cytogenetics could help better define subsets at high risk for relapse and candidates for HSCT in CR1 or subsets of patients who may have a sufficiently favorable prognosis as to preclude a major benefit from HSCT in CR1. Between January 2003 and December 2009 a total of 192 patients who were diagnosed to have AML who met the inclusion criteria were retrospectively and prospectively analysed. Between October 2008 and December 2009, 41 patients with AML were analysed for the quantitaion of LSCs. All 192 patients underwent “3+7” standard induction therapy with Daunorubucin (DNR) 50mg/m2 on days 1-3 and Cytosine Arabinoside 200mg/m2 on days 1-7. A total of 117(60.9%) patients achieved complete remission (CR) after induction. There were 47 (24.5%) induction deaths. 118 (61.5%) patients (112 in CR1, and 6 without achieving CR) received consolidation therapy. 40 (20.8%) patients underwent allo SCT, 25 (13%) auto SCT, 39(20.3%) HIDAC, and 14(7.3%) patients received chemotherapy other than HIDAC. At a median follow up of two years the Kaplan- Meier estimate of OS, EFS and DFS was 47.30± 4.30%., 37.52± 4.20% and 54.49±5.38% respectively for the entire cohort. The difference in outcomes between the different cytogenetic and molecular subgroups well as for the different modalities of consolidation did not show statistical significance. The disease free survival curves for the two subgroups above and below the median value (8.12) of WBC index were significant(p=0.0225). Thus the CD34+ and CD34+ CD38- cells in the day 10 to day 14 marrow when quantified and analysed as a continuous variable was significant to predict events(p- 0.025 and 0.024 respectively).
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Clinical Profile, Young Adult Patients, Acute Myeloid Leukemia, Molecular Markers, Leukemic Stem Cells, Clinical Outcomes. |
| Subjects: | MEDICAL > Clinical Haematology |
| Depositing User: | Subramani R |
| Date Deposited: | 01 Mar 2020 04:29 |
| Last Modified: | 01 Mar 2020 04:29 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12068 |
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