Myelotoxicity Assessment During Induction Chemotherapy in Patients With Acute Myeloid Leukemia

Abstract

Hematologic toxicity of cytostatic drugs is one of the main complications caused by induction chemotherapy for acute myeloid leukemia and ranks first position among the causes of mortality in patients at this stage of treatment. The aim of this study is to investigate the nature and occurrence rate of myelotoxicity in patients with acute myeloid leukemia during the standard induction chemotherapy. Materials and methods. The study involved 39 inpatients (23 (59%) women and 16 (41%) men, the average age of patients was 58.5±7.69) with newly diagnosed acute myeloid leukemia who took the course of treatment at hematology department of the M.V. Sklifosovsky Poltava Regional Clinical Hospital. All patients received standard courses of induction chemotherapy "7+3" or "5+2". The patients had complete blood count prior to the start of chemotherapy, on the 7th, 14th and 28th days of the first induction course. The myelotoxicity grade was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.02. Results. Myelotoxicity of chemotherapy in the treatment of acute myeloid leukemia reached the 4th highest toxicity grade on the 14th day of the first induction course and manifested by neutropenia in 22 (56.4%) patients with the development of febrile neutropenia; thrombocytopenia was detected in 11 (28.2%) with severe skin hemorrhagic syndrome and anemia was detected in 7 (17.9%) patients. Conclusions. Standard induction chemotherapy of acute myeloid leukemia has a high toxicity grade, requires regular careful monitoring of hematological parameters and supportive therapy; due to its toxicity, standard induction chemotherapy often leads to the next treatment course delay.