HEALTHCARE. 2022; 3: 61—67. CLINICAL AND HEMATOLOGICAL CHARACTERISTIC OF RELAPSES AND OBSTINATE FORMS OF ACUTE MYELOID LEUKEMIA

Objective. To analyse clinical and laboratory characteristics and survival of patients with relapses and obstinate forms of acute myeloid leukemia (AML).

Materials and methods. The study included  the clinical and laboratory data of 209 patients with de novo AML with onset of the disease in 2008—2016. We investigated the expression of the FLT3 and CD95 receptors on bone marrow cells, the level of the activated form of Akt1 in bone marrow cell lysates, mutations FLT, NPM1, CEBPA and p53. Statistical calculations were made in the statistical package R, version 3.6 using the Survival packages.

Results. The features of the clinical and laboratory characteristic of patients with relapses and obstinate AML. Obstinate AML are associated with a higher age of patients (58 [44; 69] years), while the group of relapsed AML was formed by the youngest (44 [25; 55] years) patients. Median survival was 1.3 months in the primary-resistant AML group and 30 months in the relapsed AML group. The 2- and 5-year survival rates of patients with relapsed AML were 60±7.3 and 18±5.7 months respectively. In obstinate AML was found a high expression of CD95 and FLT3. Relapsed AML was characterized by low expression of CD95 and FLT3. The expression of CD34 by bone marrow blast cells had high values in the groups of patients with obstinate and relapsed AML, and in cases of obstinate AML it was statistically significantly higher compared with relapse.

Conclusion. The management of patients with obstinate and relapsed AML is an urgent problem of modern hematology, which dictates the necessity for studies to establish risk stratification and treatment choice.

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Автор(ы): D. I. Suvorov, N. N. Klimkovich, O. V. Krasko, A. E. Silin