Types, Clinical Features and Survival Outcomes of Patients with Acute Myeloid Leukemia in Thailand: A 3-year Prospective Multicenter Study from Thai Acute Leukemia Study Group (TALSG)

Abstract Background : Acute myeloid leukemia (AML) is a common challenging hematologic malignancy worldwide. Thai data on its characteristics and outcomes has never been systematically reported. Objective : To determine clinical features and outcomes of Thai AML patients. Study design : Prospective observational study from 9 academic hospitals. Methods : Newly diagnosed AML patients were included via web-based registration. Results : A total of 679 AML patients were included. The presence of circulating peripheral blood (PB) blast was correlated with high WBC count. Acute promyelocytic leukemia (APL) had predominantly lower WBC count and higher proportion without PB blast comparing to non-APL AML. Disseminated intravascular coagulation (DIC) was commonly presented in APL (37.7%). Splenomegaly and normal platelet count were more frequently seen in Philadelphia-chromosome positive AML patients. The median follow-up time for those who survived more than 1 year was 28.0 months. One and 2-year overall survival in non-APL AML and APL patients were 31.9%, 29.6%, 88.2% and 88.2%. Hematopoietic stem cell transplantation (HSCT) could improve survival in non-APL AML. Conclusions : APL should be considered despite absence of peripheral blood blast. This study demonstrates poor outcome of Thai AML and more research to improve outcomes are underway. HSCT accessed expansion should be considered in Thailand.