الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Acute myeloid leukemia (AML) is the most common leukemia among the adult population and accounts for about 80% of all cases. It is characterized by clonal expansion of immature “blast cells” in the peripheral blood and bone marrow resulting in ineffective erythropoiesis and bone marrow failure. With recent advancements in the management guidelines, the cure rates have increased up to 15% in patients older than 60 years and about 40% in patients below 60 years of age. Despite advancements in therapeutic regimens, the prognosis remains very poor in the elderly population AML has the shortest survival (5-year survival = 24%). Curative therapies, including intensive chemotherapy and Allogeneic Stem Cell Transplantation are generally applicable to a minority of patients who are younger and fit, while most older individuals exhibit poor prognosis and survival AML is an uncommon, yet commonly-fatal myeloid malignancy whose incidence appears to be increasing. However, disparity in incidence estimates between registry-based and claims-based analyses makes it challenging to accurately document the incidence and prevalence of AML. Biologically-distinct subtypes of AML have variable prognoses, and sociodemographic and healthcare factors influence many aspects of the care of AML patients and consequently their survival. Better understanding of AML pathogenesis and predictors of response will ultimately guide therapeutic investigation and hopefully improve the clinical outcomes of AML patients Score predicting induction death with high accuracy will be a valuable tool in guiding clinicians against the use of intensive induction therapy, in tailoring of treatment as per individual patients’ risk and proper resource allocation The aim of the current study was to evaluate the outcomes of Acute Myeloid Leukemia patients, estimating the overall survival of the patients in Assuit University Hospital. It was conducted as prospective observational study on 50 Acute Myeloid Leukemia patients presented to Clinical Hematology Unit at Assuit University Hospitals in complete one-year duration The median age of the studied participants was 37 years and ranged from 19 up to 66 years, more than half aged less than 40 years, with male: female ratio of 1.17 Associated comorbidities were presented in 34.0% of the studied cases, with positive Covid-19 infection in 42.0%. About two third of the studied cases (66%) categorized as mild degree charlison comorbidity index, 24.0% categorized as moderate degree, while 10.0% categorized as sever degree charlison comorbidity index. Bleeding was the commonest clinical presenting among the studied cases documented in 90.0%, associated with anemia in 84.0%, fever in 60.0%, and weight loss in 24.0%. Night sweetening, organomealy, and back & joint pain were documented in (8.0%, 4.0%, and 4.0%) respectively. AML with monocytic differentiation (M4 and M5) represented the most prevalent FAB subtype and accounted for 50.0%, followed by AML-M2 in 30.0%, then, 20% had M3. Regarding to the risk-stratification; more than half (56%) had high leukemia risk, while 32% had low risk and 12% had intermediate leukemia risk The overall remission rate among the studied cases was 42.0%, while 12.0% needed re-induction after their 1st cycle, and only one cases (2.0%) show relapse The total mortality rate was 74.0%; about one third (32.4%) died with septic shock, 27.0% with Covid-19 infection, 18.9% with pneumonia, 13.5% due to hemorrhage, and 8.1% from neutropenic enterocolitis. Higher leukemia risk, patient’s response, and higher total leucocytic count were significant predictors for death among AML patients, meanwhile patients age, sex, smoking status, laboratory data, other than the total leucocytic count, show no effect on mortality rate among the studied cases.