Comparison of Prognostic Factors and Death Hazard Function of Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) Patients after Bone Marrow Transplantation

Abstract

Introduction: The majority of leukemia patients are acute leukemia patients, so that about 70.8% lymphoblastic leukemia were acute lymphoblastic leukemia (ALL) patients and 66.4 % of myeloid leukemia patients were acute myeloid leukemia (AML) in Tehran metropolitan. During the last two decades, intensification of therapy by the use of high-dose Cytarabine allogeneic stem cell transplantation in selected cases, paralleled by improvement in supportive care may have contributed to the impotent. In this article we use parametric survival models for recognizing prognostic factors in acute leukemia patients.
Patients and methods: Data on patients who underwent bone marrow or peripheral blood transplantation were obtained from the Hematology- Oncology and bone marrow transplantation research center at Shariati hospital, Tehran, Iran. Transplantations were performed between Oct. 17, 1993 to Jan. 31, 2007. Written informed consents for hematopoietic cell collection and transplantation were obtained from patients and donors. The study included patients 2 to 56 years of age who had received either an HLA-matched marrow transplant or a marrow transplant with a single HLA mismatch from an unrelated donor. The mean follow- up period was about 2 years after transplantation.
Results: Five hundred and seven patients were included in the study. There were 301 with acute myeloid leukemia (AML) and 206 with acute lymphoblastic leukemia (ALL). The median ages of the AML and ALL patients were 27 (2-55) and 20 years (2-52), respectively. In ALL patients, Prior viral exposure- cytomegalovirus antibody was positive in 143 patients and negative in 30 patients. In AML patients’ Prior viral exposure- cytomegalovirus antibody was positive in 220 patients and negative in 41patients. Table- 1 shows the characteristics of 507 patients who included in the study.
Conclusion: In spite of no significant difference in follow-up time, serological status (CMV), donor-recipients sex match, bone marrow cell dose(WBC, CD34, MNC), donor type, source of stem cell, graft type, and conditioning regimen, (Busulfan- Oral, Cyclophosphamide, ALG/AIS/ATG, Stoposide)(Table- 1) in both AML and ALL patients, generalized gamma distribution shows that the mean of SBMT in AML patients is 2.52 times of ALL patients.