Original Article

International Journal of Hematology

, Volume 96, Issue 3, pp 342-349

First online:

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

  • Takuya MatsunagaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of MiyazakiDivision of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Kagawa University
  • , Kiyoshi YamashitaAffiliated withMiyazaki Prefectural Miyazaki Hospital
  • , Yoko KubukiAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
  • , Takanori ToyamaAffiliated withMiyazaki Prefectural Nobeoka Hospital
  • , Osamu ImatakiAffiliated withDivision of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Kagawa University
  • , Kouichi MaedaAffiliated withMiyakonojo National Hospital
  • , Noriaki KawanoAffiliated withMiyazaki Prefectural Miyazaki Hospital
  • , Seiichi SatouAffiliated withFujimoto Hayasuzu Hospital
  • , Hiroshi KawanoAffiliated withKoga General Hospital
    • , Junzo IshizakiAffiliated withMiyazaki Prefectural Nichinan Hospital
    • , Shuro YoshidaAffiliated withMiyazaki Prefectural Miyazaki Hospital
    • , Takuro KamedaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Tadashi SasakiAffiliated withMiyazaki Prefectural Nobeoka Hospital
    • , Masaaki SekineAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Ayako KamiuntenAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Yasuhiro TaniguchiAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Tomonori HidakaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Keiko KatayoseAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Haruko K-ShimodaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Kotaro ShideAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Shojiro YamamotoAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Hiroshi MoritakeAffiliated withDivision of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of Medicine, University of Miyazaki
    • , Hiroyuki NunoiAffiliated withDivision of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of Medicine, University of Miyazaki
    • , Shigeyoshi MakinoAffiliated withMiyazaki Prefectural Miyazaki Hospital
    • , Akira KitanakaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki
    • , Hitoshi MatsuokaAffiliated withKoga General Hospital
    • , Kazuya ShimodaAffiliated withDepartment of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki Email author 

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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 study Clinical practice