Clinical Characteristics and Treatment Outcomes of Acute Myeloid Leukemia in Adolescent and Young Adult versus Adult Patients: A Single-Center Experience in Qatar.

Abstract

Acute myeloid leukemia (AML) presents differently across age groups, with unique challenges in the adolescent and young adult (AYA) populations. This study compares clinical characteristics and outcomes between AYA and adult AML patients in Qatar. We conducted a retrospective analysis of 151 AML patients treated at the National Center for Cancer Care and Research, Qatar, between 2017-2021. Patients were divided into AYA (15-39 years, n=73) and adults (≥40 years, n=78) groups. Clinical characteristics, cytogenetic profiles, treatment approaches and survival outcomes were compared between groups. AYA patients (median age 30 years) showed distinct characteristics compared to adults (median age 53.9 years). AYA patients had lower platelet counts (62,900/mm³ versus 96,500/mm³, p=0.016) and higher blast percentages in peripheral blood and bone marrow (60% versus 40%, p=0.02). Core binding factor rearrangements were more common in AYA patients (32% versus 12%, p=0.03), while adult patients had more diploid karyotypes (55% versus 36%). AYA patients received more intensive therapy, with higher rates of FLAG-Ida salvage therapy (34% versus 15%) and allogeneic transplantation (32% versus 15%, p=0.01). While transplantation significantly improved survival in adults, its impact was less pronounced in AYA patients. Median overall survival was comparable between groups (23.14 versus 24.08 months, p=0.09). Our study reveals distinct biological and clinical characteristics between AYA and adult AML patients in Qatar. Despite receiving more intensive therapy, AYA patients showed comparable survival outcomes to adults, suggesting the need for age-specific treatment approaches. The differential impact of transplantation between age groups highlights the importance of personalized treatment strategies. These findings contribute to understanding age-specific differences in AML and may help optimize treatment approaches for both populations.