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Very early death within 30 days after diagnosis in patients with acute myeloid leukemia

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Abstract

Acute myeloid leukemia (AML) is a malignancy that requires immediate treatment. However, the factors that predict very early mortality are not well known. We retrospectively analyzed 70 patients who were newly diagnosed with AML at our institution between 2014 and 2020. Very early death within 30 days after the initial consultation with a hematologist occurred in eight patients, including seven men. They were older than 30-day survivors (70.5 vs. 47 years, P < 0.01). In addition, four patients with a low score on the Glasgow Coma Scale (GCS) at diagnosis died within 30 days, and half of the early death group died due to cerebral hemorrhage. We next tried to predict early death using a ROC curve. Age, hemoglobin (Hb), estimated glomerular filtration rate (eGFR) and the international normalized ratio of prothrombin time (PT-INR) all had an area under the curve of greater than 0.8 for predicting very early death. A multivariate analysis revealed that older age (OR = 1.14, P = 0.033), Hb (OR = 0.48, P = 0.05), and low GCS (OR = 140.0, P = 0.0073) were significantly associated with very early death. Further studies will be needed to confirm which patients are at high risk for early death and to improve the treatment strategy for such patients.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

The authors are grateful for the contributions of all of the participating patients, physicians, co-workers, and data managers at Jichi Medical University Saitama Medical Center.

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Authors and Affiliations

  1. Division of Hematology, Saitama Medical Center, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya-Ku, Saitama, 330-8503, Japan

    Machiko Kusuda, Hideki Nakasone, Yuhei Nakamura, Masakatsu Kawamura, Junko Takeshita, Shunto Kawamura, Nozomu Yoshino, Yukiko Misaki, Kazuki Yoshimura, Shimpei Matsumi, Ayumi Gomyo, Aki Tanihara, Masaharu Tamaki, Kazuaki Kameda, Shun-ichi Kimura, Shinichi Kako & Yoshinobu Kanda

Authors
  1. Machiko Kusuda
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  2. Hideki Nakasone
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  3. Yuhei Nakamura
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  4. Masakatsu Kawamura
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  5. Junko Takeshita
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  6. Shunto Kawamura
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  7. Nozomu Yoshino
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  8. Yukiko Misaki
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  9. Kazuki Yoshimura
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  10. Shimpei Matsumi
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  11. Ayumi Gomyo
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  12. Aki Tanihara
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  13. Masaharu Tamaki
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  14. Kazuaki Kameda
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  15. Shun-ichi Kimura
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  16. Shinichi Kako
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  17. Yoshinobu Kanda
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Contributions

MK designed the study, collected data, analyzed data, and wrote the manuscript. HN gave advice on the methods, analyzed data, and wrote the manuscript. YN, MK, JT, SK, NY, YM, KY, SM, AG, AT, MT, KK, SK and SK collected clinical data and revised the manuscript. YK designed the study, gave advice on the methods, wrote the manuscript, and was responsible for the project.

Corresponding author

Correspondence to Yoshinobu Kanda.

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On behalf of all the authors, the corresponding author states that there is no conflict of interest.

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Kusuda, M., Nakasone, H., Nakamura, Y. et al. Very early death within 30 days after diagnosis in patients with acute myeloid leukemia. Int J Hematol 117, 198–205 (2023). https://doi.org/10.1007/s12185-022-03482-x

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  • DOI: https://doi.org/10.1007/s12185-022-03482-x

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