Clinical Characteristics, Treatment Approaches, and Survival Predictors in Adult Acute Myeloid Leukemia: Interim Results from the Turkish Society of Hematology AML Registry

<b>Background</b>: Acute myeloid leukemia (AML) is an aggressive and biologically diverse hematologic cancer that disproportionately affects older individuals. Despite advances in molecular profiling and therapy, long-term outcomes remain unsatisfactory. This nationwide registry was established to provide real-world insights into clinical characteristics, treatment strategies, and survival among adult AML patients in Turkey. <b>Methods</b>: The Turkish AML Registry Project (ClinicalTrials.gov Identifier: NCT05979675) combines retrospective and prospective data from 23 tertiary hematology centers. Adult patients diagnosed between January 2008 and July 2023 were included. Baseline demographics, European LeukemiaNet (ELN) 2017 risk groups, Eastern Cooperative Oncology Group (ECOG) performance status, treatment intensity, and targeted therapy use were analyzed. Response and survival outcomes were assessed using Kaplan-Meier methods. <b>Results</b>: The interim dataset included 891 patients (median age 58 years, 45.5% ≥60). Intensive chemotherapy, most commonly 7 + 3, was applied in 74.1%, while 25.9% received lower-intensity regimens. Targeted agents, mainly venetoclax, were incorporated more frequently into low-intensity therapies (19.1% vs. 3.4%, <i>p</i> < 0.001). Complete remission occurred in 70.2% after intensive and 35.9% after low-intensity therapy, improving to 51.4% with targeted agents. Median overall survival (OS) was 27.2 months, with 1-year OS rates of 54.1%, 28.9%, and 17.6% for favorable, intermediate, and adverse ELN groups (<i>p</i> < 0.001). ECOG 0-1 predicted superior survival (1-year OS 70.3% vs. 47.0%). <b>Conclusions</b>: Nationwide real-world evidence underscores the prognostic relevance of ELN risk and functional status in AML. While intensive chemotherapy remains central, combining targeted agents with low-intensity regimens improves outcomes in less fit patients and supports personalized treatment approaches.

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Journal
Journal of Clinical Medicine
Published
2025-10-18
DOI
https://doi.org/10.3390/jcm14207367
Primary Topic
Acute Myeloid Leukemia Research
Type
article
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article

Clinical Characteristics, Treatment Approaches, and Survival Predictors in Adult Acute Myeloid Leukemia: Interim Results from the Turkish Society of Hematology AML Registry

Aylin Fatma Karatas, Fatih Demırkan, Hale Bülbül, Senem Maral et al.
Journal of Clinical Medicine
Acute Myeloid Leukemia Research
article

Clinical Characteristics, Treatment Approaches, and Survival Predictors in Adult Acute Myeloid Leukemia: Interim Results from the Turkish Society of Hematology AML Registry

Aylin Fatma Karatas, Fatih Demırkan, Hale Bülbül, Senem Maral, Ferda Can, Emel Merve Yenihayat, Hakkı Onur Kırkızlar, Demet Çekdemir, Burak Devecı, Ümi̇t Yavuz Malkan, Süreyya Yiğit Kaya, Aydan Akdeniz, Ünal Ataş, Salih Sertaç Durusoy, İbrahim Ethem Pınar, Ceyda Aslan, Hakan Göker, Fahir Özkalemkaş, İdris İnce, Volkan Karakuş, Ömür Gökmen Sevindik, Güldane Cengiz Seval, Gülten Korkmaz, Demircan Özbalcı, Serhat Çelik, Utku İltar, Selami Koçak Toprak, Merve Gökçen Polat, Hacer Berna Afacan Öztürk, Muzaffer Keklık, Zeynep Tuğba Güven, Özgür Mehtap, Fatma Aykaş, Murat Kaçmaz, Ali Doğan, Ramazan Erdem, İnci Alacacıoğlu
article en

Abstract

<b>Background</b>: Acute myeloid leukemia (AML) is an aggressive and biologically diverse hematologic cancer that disproportionately affects older individuals. Despite advances in molecular profiling and therapy, long-term outcomes remain unsatisfactory. This nationwide registry was established to provide real-world insights into clinical characteristics, treatment strategies, and survival among adult AML patients in Turkey. <b>Methods</b>: The Turkish AML Registry Project (ClinicalTrials.gov Identifier: NCT05979675) combines retrospective and prospective data from 23 tertiary hematology centers. Adult patients diagnosed between January 2008 and July 2023 were included. Baseline demographics, European LeukemiaNet (ELN) 2017 risk groups, Eastern Cooperative Oncology Group (ECOG) performance status, treatment intensity, and targeted therapy use were analyzed. Response and survival outcomes were assessed using Kaplan-Meier methods. <b>Results</b>: The interim dataset included 891 patients (median age 58 years, 45.5% ≥60). Intensive chemotherapy, most commonly 7 + 3, was applied in 74.1%, while 25.9% received lower-intensity regimens. Targeted agents, mainly venetoclax, were incorporated more frequently into low-intensity therapies (19.1% vs. 3.4%, <i>p</i> < 0.001). Complete remission occurred in 70.2% after intensive and 35.9% after low-intensity therapy, improving to 51.4% with targeted agents. Median overall survival (OS) was 27.2 months, with 1-year OS rates of 54.1%, 28.9%, and 17.6% for favorable, intermediate, and adverse ELN groups (<i>p</i> < 0.001). ECOG 0-1 predicted superior survival (1-year OS 70.3% vs. 47.0%). <b>Conclusions</b>: Nationwide real-world evidence underscores the prognostic relevance of ELN risk and functional status in AML. While intensive chemotherapy remains central, combining targeted agents with low-intensity regimens improves outcomes in less fit patients and supports personalized treatment approaches.

Journal of Clinical MedicineVol. 14(20)
Van Yüzüncü Yıl Üniversitesi (TR), Trakya University (TR), Bursa Uludağ Üni̇versi̇tesi̇ (TR), Izmir University (TR), Ankara University (TR), Manisa Celal Bayar University (TR), University of Health Science (KH), Süleyman Demirel Üniversitesi (TR), Dokuz Eylül University (TR), Akdeniz University (TR), Niğde Ömer Halisdemir Üniversitesi (TR), Istanbul Medipol University (TR), Gaziantep Children's Hospital (TR), Memorial Ankara Hospital (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Sağlık Bilimleri Üniversitesi (TR), Sanko University (TR), Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi (TR), Antalya IVF (TR), Mustafa Kemal University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Hacettepe University (TR), University of Health Sciences Antigua (AG), Erciyes University (TR)
Openalex Percentile: Top 62%
Acute Myeloid Leukemia Research
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