30-Day Mortality and Factors Associated with Induction-Related Death Following 7+3 Chemotherapy in Patients with Acute Myeloid Leukemia at Maharat Nakhon Ratchasima Hospital.
Keywords:
Acute myeloid leukemia, induction chemotherapy, 7+3 regimen, mortality, hypoalbuminemia, hyponatremiaAbstract
This retrospective cohort study aimed to investigate 30-day mortality rates and factors associated with mortality during remission-induction therapy using the "7+3" chemotherapy regimen in patients with acute myeloid leukemia (AML) at Maharat Nakhon Ratchasima Hospital. Data were collected from the electronic medical records of patients with AML (aged ≥15 years) who received the 7+3 regimen between 2016 and 2019. Baseline characteristics, mortality rates, and risk factors were analyzed using univariable and multivariable logistic regression.
Results: A total of 78 patients were included. The 30-day mortality rate was 38.5% (30/78). Most demographic factors were not significantly different between survivors and non-survivors. However, the mortality group had significantly lower lymphocyte percentage, serum albumin, sodium, and calcium levels, and higher LDH, INR, and PT values. In univariable analysis, serum albumin, sodium, and lymphocyte percentage were significantly associated with mortality. In multivariable analysis, serum albumin (Adjusted OR 0.17; 95% CI 0.05–0.63; p = 0.008) and serum sodium (Adjusted OR 0.78; 95% CI 0.63–0.94; p = 0.020) remained independent predictors of 30-day mortality.The most common causes of death were pneumonia and bloodstream infections, with Gram-negative organisms being the predominant pathogens.
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