A multicenter comparative acute myeloid leukemia study: can we explain the differences in the outcomes in resource-constrained settings?

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Arquivos
art_SILVEIRA_A_multicenter_comparative_acute_myeloid_leukemia_study_can_2021.PDF (3.02 MB)
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
TAYLOR & FRANCIS LTD
Autores
COELHO-SILVA, Juan L.
VALLANCE, Grant
PEREIRA-MARTINS, Diego A.
MADEIRA, Maria I. A.
FIGUEREDO-PONTES, Lorena L.
SIMOES, Belinda P.
PENIKET, Andy
Citação
LEUKEMIA & LYMPHOMA, v.62, n.1, p.147-157, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Outcomes in acute myeloid leukemia (AML) are dependent on patient- and disease-characteristics, treatment, and socioeconomic factors. AML outcomes between resource-constrained and developed countries have not been compared directly. We analyzed two cohorts: from Sao Paulo state, Brazil (USP,n = 312) and Oxford, United Kingdom (OUH,n = 158). USP cohort had inferior 5-year overall survival compared with OUH (29% vs. 49%, adjusted-p=.027). USP patients have higher early-mortality (23% vs. 6%p<.001) primarily due to multi-resistant Gram-negative bacterial and fungal infections. USP had higher 5-year cumulative incidence of relapse (60% vs. 50%,p=.0022), were less likely to undergo hematopoietic stem cell transplant (HSCT) (28% vs. 75%,p<.001) and waited longer for HSCT (median, 23.8 vs. 7.2 months,p<.001). Three-year survival in relapsed patients was worse in USP than OUH (10% vs. 39%,p<.001). Our study indicates that efforts to improve AML outcomes in Brazil should focus on infection prevention and control, and access to HSCT.
Palavras-chave
Acute myeloid leukemia, survival, early mortality, infection, stem-cell transplant
URI
https://observatorio.fm.usp.br/handle/OPI/39067
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/31
Artigos e Materiais de Revistas Científicas - ODS/03