Comparison of regimens targeting complete remission in the first-line treatment of acute myeloid leukemia patients.

Abstract

Objective: Standard treatment for adults with acute myeloid leukemia (AML) involves anthracycline and cytarabine, while alternative regimens are necessary for elderly and frail patients. This study aims to compare the effectiveness and safety of various induction regimens in AML patients.

Patients and methods: The retrospective study included 130 adult AML patients treated at a tertiary care center from January 2014 to December 2022. Patients received one of the following induction regimens: anthracycline and cytarabine (n = 82), azacitidine and venetoclax (n = 11), etoposide and cytarabine (n = 22), or reduced-dose anthracycline and cytarabine (n = 15). Data on demographics, clinical characteristics, treatment-related toxicities, and infectious complications were collected. Outcomes included overall survival and remission rates.

Results: The anthracycline and cytarabine regimen demonstrated the highest overall survival rate, although remission rates did not significantly differ among the treatment groups. Patients receiving azacitidine and venetoclax experienced a significantly longer duration of neutropenia. The use of antiviral prophylaxis increased over the study period, reflecting improved management strategies. Infection remained the leading cause of mortality.

Conclusions: Effective management of prolonged neutropenia and infections is crucial for improving patient outcomes. Future research should focus on optimizing prophylactic and infection treatment strategies to further enhance survival in AML.