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

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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.

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Acknowledgments

We appreciate the work of data manager and statistical support from Mrs. Mayumi Ebihara and Mrs. Keiko Toyama of Miyazaki University, and Mrs. Rie Nitawaki of Kagawa University.

Conflict of interest

The authors declare no competing financial interests in relation to this work.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Takuya Matsunaga, Yoko Kubuki, Takuro Kameda, Masaaki Sekine, Ayako Kamiunten, Yasuhiro Taniguchi, Tomonori Hidaka, Keiko Katayose, Haruko K-Shimoda, Kotaro Shide, Shojiro Yamamoto, Akira Kitanaka & Kazuya Shimoda

  2. Miyazaki Prefectural Miyazaki Hospital, Kitatakamatsu 5-30, Miyazaki, 880-8510, Japan

    Kiyoshi Yamashita, Noriaki Kawano, Shuro Yoshida & Shigeyoshi Makino

  3. Miyazaki Prefectural Nobeoka Hospital, Shinkouji 2-1-10, Nobeoka, 882-0835, Japan

    Takanori Toyama & Tadashi Sasaki

  4. Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Takuya Matsunaga & Osamu Imataki

  5. Miyakonojo National Hospital, Iwayoshi-cho 5033-1, Miyakonojo, 885-0014, Japan

    Kouichi Maeda

  6. Fujimoto Hayasuzu Hospital, Hayasuzumachi 17-1, Miyakonojo, 885-0055, Japan

    Seiichi Satou

  7. Koga General Hospital, Sudaki 1749-1, Ikeuchi-cho, Miyazaki, 880-0041, Japan

    Hiroshi Kawano & Hitoshi Matsuoka

  8. Miyazaki Prefectural Nichinan Hospital, Kiyama 1-19-5, Nichinan, 887-0013, Japan

    Junzo Ishizaki

  9. Division of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Hiroshi Moritake & Hiroyuki Nunoi

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  1. Takuya Matsunaga
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Corresponding author

Correspondence to Kazuya Shimoda.

Additional information

T. Matsunaga, K. Yamashita, Y. Kubuki, T. Toyama, and O. Imataki contributed equally to this work.

Electronic supplementary material

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12185_2012_1146_MOESM1_ESM.tif

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

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)

Supplemental Table 1 (TIFF 71 kb)

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Matsunaga, T., Yamashita, K., Kubuki, Y. et al. Acute myeloid leukemia in clinical practice: a retrospective population-based cohort study in Miyazaki Prefecture, Japan. Int J Hematol 96, 342–349 (2012). https://doi.org/10.1007/s12185-012-1146-2

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