International Journal of Hematology

, Volume 96, Issue 3, pp 342–349

Acute myeloid leukemia in clinical practice: a retrospective population-based cohort study in Miyazaki Prefecture, Japan

Authors

  • Takuya Matsunaga
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
    • Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal MedicineKagawa University
  • Kiyoshi Yamashita
    • Miyazaki Prefectural Miyazaki Hospital
  • Yoko Kubuki
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Takanori Toyama
    • Miyazaki Prefectural Nobeoka Hospital
  • Osamu Imataki
    • Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal MedicineKagawa University
  • Kouichi Maeda
    • Miyakonojo National Hospital
  • Noriaki Kawano
    • Miyazaki Prefectural Miyazaki Hospital
  • Seiichi Satou
    • Fujimoto Hayasuzu Hospital
  • Hiroshi Kawano
    • Koga General Hospital
  • Junzo Ishizaki
    • Miyazaki Prefectural Nichinan Hospital
  • Shuro Yoshida
    • Miyazaki Prefectural Miyazaki Hospital
  • Takuro Kameda
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Tadashi Sasaki
    • Miyazaki Prefectural Nobeoka Hospital
  • Masaaki Sekine
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Ayako Kamiunten
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Yasuhiro Taniguchi
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Tomonori Hidaka
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Keiko Katayose
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Haruko K-Shimoda
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Kotaro Shide
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Shojiro Yamamoto
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Hiroshi Moritake
    • Division of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of MedicineUniversity of Miyazaki
  • Hiroyuki Nunoi
    • Division of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of MedicineUniversity of Miyazaki
  • Shigeyoshi Makino
    • Miyazaki Prefectural Miyazaki Hospital
  • Akira Kitanaka
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
  • Hitoshi Matsuoka
    • Koga General Hospital
    • Department of Gastroenterology and Hematology, Faculty of MedicineUniversity of Miyazaki
Original Article

DOI: 10.1007/s12185-012-1146-2

Cite this article as:
Matsunaga, T., Yamashita, K., Kubuki, Y. et al. Int J Hematol (2012) 96: 342. doi:10.1007/s12185-012-1146-2

Abstract

We performed a retrospective population-based cohort study of acute myeloid leukemia (AML) in Miyazaki Prefecture, Japan. Over 6 years, we diagnosed 221 patients (211 adults and 10 children) with AML, indicating an incidence of AML in Miyazaki Prefecture of 3.2 per 100,000 per year. In 193 adult patients with non-acute promyelocytic leukemia (APL), the proportion of patients with myelodysplasia, unfavorable risk karyotypes, antecedent hematologic diseases, prior chemotherapy for other malignancies, and small proportion of blasts in the marrow was higher in patients ≥65 years, and patients with poor performance status (PS) and higher WBC counts at diagnosis were more prevalent among patients ≥75 years. One-third of the adult non-APL patients met the inclusion criteria usually applied in clinical trials: de novo AML, age ≤64 years with PS 0–2 and no key organ dysfunction. The 5-year overall survival (OS) rate of adult non-APL patients was 21.1 % (patients ≤64 years, 33.8 %; 65–74 years, 21.6 %; ≥75 years, 0 %). Multivariate analysis revealed that French-American-British subtypes M0, M6, and M7, poor PS (3, 4), unfavorable risk karyotypes, and higher WBC counts at diagnosis were independent adverse prognostic factors associated with OS. This analysis provides real world data.

Keywords

Acute myeloid leukemia (AML)Population-based studyClinical practice

Supplementary material

12185_2012_1146_MOESM1_ESM.tif (61 kb)
Supplemental Fig. 1. Negative correlation between performance status and intensity of induction chemotherapy in 108 non-acute promyelocytic leukemia patients aged ≥ 65 years. No shading, intensive chemotherapy; gray shading, less intensive chemotherapy; black shading, best supportive care (TIFF 60 kb)
12185_2012_1146_MOESM2_ESM.tif (60 kb)
Supplemental Fig. 2. Kaplan–Meier estimate of overall survival in 46 non-acute promyelocytic leukemia patients aged ≥ 70 years with PS 0–2 categorized by intensity of induction chemotherapy. Black line, intensive chemotherapy; gray line, less intensive chemotherapy (TIFF 59 kb)
12185_2012_1146_MOESM3_ESM.tif (71 kb)
Supplemental Table 1 (TIFF 71 kb)

Copyright information

© The Japanese Society of Hematology 2012