Abstract

Introduction: Little is known about the outcomes of Adolescent and young adults (AYAs); aged 15-39 years with acute myeloid leukemia (AML) worldwide, so, we evaluated the clinical characteristics, response to therapy, and survival outcomes of these patients.

Patients and Methods: In this observational prospective cohort study, we investigated 64 AYA AML patients, divided by their age at diagnosis into two groups, (AYA 16-29 years) and (AYA 30-39 years); including 26 and 20 patients, respectively. Patient and disease characteristics, in addition to treatment and survival outcomes, were analyzed using statistical package for social science software version 24

Results: The median age of the whole group was 29 years, with male-to-female ratio 1.3. The most common FAB subtypes were M2 and M4, 30.4% (for each subtype). Normal karyotyping represented the most frequent cytogenetic risk group (65.2%). An intensive induction therapy was given to most patients (82.6%) and a significant difference was found between the 2 patient groups regarding karyotyping and intensive induction therapy, P-value <0.001 and 0.048, respectively.

The complete remission rate was (65.2%) and the relapse rate was 40.0% which was significantly higher in the (AYA 16-29 year) group, P<0.001.

The 3-Year leukemia-free survival (LFS) rate was 23.6% and was significantly better within the (AYA 30-39 years) group, p-value = 0.002. While there was no significant difference in overall survival rates.

Conclusion: AYA patients constitute a unique subset of patients with AML with an improved prognosis especially those aged from 30-39 years, who had better LFS and lower relapse rates.

Keywords: Adolescent and young adults (AYAs), acute myeloid leukemia (AML), survival, prognosis.