ABSTRACT
Acute myeloid leukemia (AML) is a neoplasm of progenitor hematopoietic cells that results in
loss of the ability to differentiate from the myeloid lineage, leading to insufficient generation
of mature blood cells. LMA is a genetically heterogeneous disease, which occurs most
commonly in adults, with increasing incidence with increasing age. The diagnosis, according
to the World Health Organization - WHO, requires the presence of 20% of blasts in the bone
marrow. It is a highly aggressive disease with a still very low survival rate despite
chemotherapeutic treatment, with the exception of acute promyelocytic leukemia. The
objective of this study is to characterize the clinical and epidemiological profile of AML
patients in the State of Amazonas treated in HEMOAM. The study was retrospective, cross-
sectional, including all patients diagnosed with AML between January 2013 and December
2017.were 194 patients diagnosed in this period, patients who were not treated exclusively in
HEMOAM, and the medical records were not found were excluded. The median age of the
population was 46 years, 70,94% were of the non-white race, the distribution between men
and women 96:83.The most frequent clinical manifestations were asthenia (65.89%), other
associated symptoms (50,28%), fever (48,55%), and bleeding (31,21%). The majority of the
population (45.97%) had a performance status according to the ECOG score of (2). The most
frequent FAB subtypes found in this work was M5 followed by M3.The median of
hemoglobin was 8.4 (4.1 -14) g\/dl, with median VCM 89 (69.10 interval -115.8) fl. The
median of the Leukocyte count was 11660\/mm3 and platelet median was 43000\/mm3.
Median (%) peripheral blood blasts was 26% and the bone marrow 71%. With respect to the
risk cytogenetic (68%) karyotypes are intermediate risk. In immunophenotyping was the most
common marker CD13 being expressed (91,51%) of the cases. Of the findings 53,93%
expressed aberrant antigens, with CD7 being most expressed in the T lymphoid line and
CD19 in the B lymphoid line. A total of 5 patients were classified as acute bifenotypic
leukemia (LAB). The most used treatment lineage in the adult was 3+7, in the children was
the BFM 2004. A total of 134 patients were submitted to intensive therapy of which 74
entered in remission. Nine (9) of the patients underwent allogeneic hematopoietic stem cell
transplantation. The rate of relapse and refractory were raised. The overall survival at 1 year
was 31.28%. The death rate was 67.59%. The survival curves showed that better prognosis
was related to the age below of 60 years (median 496dias; p-value < 0.0001; OR 0.2774),
patient with AML de novo (median 264dias; p-value 0.0103; OR 0.3858).There was no
statistically significant difference when comparing overall survival curves with the
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cytogenetics, the leukocytes more or less de100x10e3\/μ l, and patients who did or didn't
BMT. Conclusion, the results obtained made it possible to obtain a profile of demographic
and clinical features of AML in the Amazon, provide important tools for a possible
development of surveillance systems.
Keywords. Acute myeloid leukemia, haematological malignancies
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