Outcome of Induction Therapy for Newly Diagnosed Acute Leukemia in a Calendar Year: Real World Data from a Tertiary Care Cancer Centre in South India

Remission induction is the most intensive course of acute leukemia treatment. There is paucity of contemporary data on outcomes of induction from developing countries. In this study from a tertiary care centre in South India we report induction outcomes for all cases of acute leukemia (n = 109, ALL = 71 and AML = 38) registered in department of Medical Oncology in the calendar year 2015. 76 patients were in pediatric age group (≤ 18 years) and 33 were adults, male to female ratio was 1.6:1. All febrile neutropenia related events were more in AML, with early onset (median day to onset was day 8 in AML vs. day 17 in ALL), higher severity (94% clinically or microbiologically documented infection in AML vs. 61% in ALL), increased fungal infections (25% probable fungal pneumonia in AML vs. 6% in ALL) and consequently with more resource utilization. CR rate for ALL was 70%and 53% for AML. Fatal induction events were recorded in 17.6% ALL and 34.3% AML. Mortality during induction therapy of acute leukemia is high in resource limited settings, higher in AML than ALL, mostly because of infections (74% of induction deaths). There is a vital need for analysis of resources and improvement in supportive care during acute leukemia induction.

Keywords: acute leukemia, induction, outcome, South India.