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Akut Miyeloid Lösemi Remisyon İndüksiyon Kemoterapisinde Farklı Antrasiklinlerin Rolü

The Role of Different Anthracyclines in Remission Induction Therapy for Acute Myeloid Leukemia

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2010

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Keywords (Original Language):

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Abstract (2. Language): 
Acute myeloid leukemia (AML) is a neoplastic disorder of hematopoietic stem cells. Its incidence increases with advancing age and is higher in men than in women. Remission induction therapy is the first step in AML treatment. Cytarabine and anthracycline combination is used for standart induction therapy. In this study, we aimed to determine the effects of different anthracycline types on achieving remission and supportive therapy. Therefore, we evaluated retrospectively complete remissions in 96 of 123 patients who were hospitalized in the clinic of Hematology of Uludag University Hospital in a 6-year period from January 2004 to December 2009, and received 3+7 induction therapy for the diagnosis of AML. Of 96 patients included, 44 (45.8%) were women and 52 (54.2%) were men. The most frequent FAB subtypes were M2 (29.3%), M3 (15.4%) and M4 (13.0%). The anthracycline types and the patient numbers receiving the drugs were as follows: idarubicin (72 patients, 75%), doxorubicin (12 patients, 12.5%), daunorubicin (9 patients, 9.4%) or mitoxantrone (3 patients, 3.1%). The patients treated with doxorubicin had the shortest period of neutropenia (median 16.5 days, range 5 to 23 days). The duration of antibiotic use was mostly prolonged in patients treated with idarubicin (median 27 days, range 10 to 45 days). The average follow-up period of our patients was 25.7 months with a median of 15 months (range 2 to 70 months). Of these patients, 33 (34.4%) relapsed during follow-up. Early relapse (<12 months) was found in 21 patients (21.9%) and late relapse (>12 months) was found in 12 patients (12.5%). Of our patients, 54 (56.2%) are still alive and 42 (43.8%) died. As a result, while the induction chemotherapies containing different antracycline types may have similarities in terms of treatment success, they may cause differences in supportive therapy.
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Abstract (Original Language): 
Akut miyeloid lösemi (AML), hemopoetik kök hücresinin neoplastik hastalığıdır. AML insidansı yaş ile birlikte artış gösterir ve erkeklerde kadınlara göre daha fazla oranda tespit edilmektedir. Remisyon indüksiyon kemoterapisi, AML tedavisinin birinci basamağıdır. Standart indüksiyon tedavisinde sitarabin ve antrasiklin kombinasyonu kullanılır. Bu çalışmada amacımız, AML remisyon indüksiyon kemoterapisinde farklı antrasiklin tiplerinin remisyon elde etmede ve destek tedavi gereksiniminde fark yaratıp yaratmadığını belirlemektir. Bunun için Ocak 2004–Aralık 2009 arasında toplam 6 yıllık sürede Uludağ Üniversitesi Hastanesi Hematoloji Kliniği’nde yatarak tedavi gören, AML tanısıyla 3+7 remisyon indüksiyon kemoterapisi alan 123 olgudan tam remisyona giren 96 olgu geriye dönük olarak değerlendirildi. Alınan 96 hastanın 44’ü (%45,8) kadın, 52’si (%54,2) erkekti. En sık FAB alt tipleri: M2 (%29,3), M3 (%15,4) ve M4 (%13,0) idi. Hasta sayıları ve aldıkları antrasiklin tipleri: idarubisin (72 hasta, %75), doksorubisin (12 hasta, %12,5), daunorubisin (9 hasta, %9,4) veya mitoksantron (3 hasta, %3,1) idi. Nötropeni süresi en kısa doksorubisin alan grupta idi (ortanca 16,5 gün; aralık 5-23). Antibiyotik kullanılan gün sayısı en uzun idarubisin alan grupta (ortanca 27 gün; aralık 10-45) idi. Hastalarımızın ortalama izlem süresi 25,7 ay, ortanca 15 ay (2-70 ay) idi. Bu hastaların 33’ünün (%34,4) takiplerinde nüks ettiği görüldü. 21 hastada erken nüks (%21,9) (<12 ay) ve 12 hastada geç nüks (%12,5) (>12 ay) bulundu. Hastalarımızın 54’ü (%56,2) hayatta olup, 42’si (%43,8) hayatını kaybetmişti. Sonuç olarak, farklı antrasiklin içeren indüksiyon kemoterapileri tedavi başarıları açısından benzer özellikler gösterirken destek tedavi ihtiyacı açısından farklılıklar gösterebilmektedir.
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