Age and full blood count parameters predict survival in acute myeloid leukaemia at a Cape Town tertiary academic centre

Abstract

Background: Acute myeloid leukaemia (AML) is a common and aggressive haematological neoplasm. Limited studies of AML in South Africa have shown differences in age at diagnosis and overall survival (OS) compared to international studies.
Aim: To determine the demographics, subtype and OS of AML.
Setting: The study was conducted at the National Health Laboratory Service at Tygerberg Hospital, Cape Town, South Africa.
Methods: Patients with newly diagnosed AML from 2015 to 2018 were identified. The diagnostic subtype and prognostic group for each AML was determined. Survival analysis was performed.
Results: Ninety patients were included. The median age of adults was 54 years (interquartile range [IQR] 38 years – 65 years, n = 77), and for children was 2 years (IQR 2 years – 7 years, n = 13). The male-to-female ratio was 1:1.4. Acute promyelocytic leukaemia (21%) and AML myelodysplasia related (19%) were the commonest subtypes. The 3-year OS in children, adults < 60 years and adults ≥ 60 years was 46%, 21% and 3%, respectively. Adverse risk group increased risk of death (p = 0.003, n = 38). Age, white cell count and platelet count were independent risk factors for death.
Conclusion: In contrast to high-income countries, our findings show a younger age at AML diagnosis, a female predominance and a lower OS. Age and full blood count (FBC) parameters are important predictors for OS.
Contribution: The findings complement other studies published in South Africa, showing younger age at diagnosis and inferior OS of AML, while highlighting the importance of FBC findings.