Longterm Outcome of Adults With Acute Myeloid Leukemia on the Basis of Their Risk Stratification in a Tertiary Care Hospital

This study aims to assess the long-term outcomes of AML patients in LMICs, focusing on survival rates, relapse, and post-treatment morbidity, as well as factors influencing these outcomes in resource-limited settings. We analyzed the outcome of newly diagnosed AML patients who underwent chemotherapy at Aga Khan University Hospital Karachi. A total of 178 eligible patients were available for assessment. Cytogenetic and molecular workup of 152 patients was available according to which 11.8% were favorable risk, 54.6% were intermediate risk and remaining 33.5% were poor risk. Among these 178 patients who underwent chemotherapy 58.42% achieved remission, 12.92% experienced induction failure and 28.56% died during induction. A total of 13.48% patients were long term survivors who remained disease free at 5 years of follow-up. 20.79% relapsed within 1 year of therapy and 10.11% relapsed after 1 year but within 5 years. 15 patients who were disease free at 2 years did not follow up beyond that period. On the basis of risk assessment 72.22% patients in favorable risk, 51.8 % in intermediate risk and 45.09% in poor risk category achieved remission. And 27.78% favorable risk, 9.64% intermediate risk and 11.76% poor risk category were long term survivors. These results suggest long-term outcomes for AML patients in LMICs are significantly influenced by healthcare system limitations, socioeconomic challenges, and lack of access to novel therapies. To improve survival and quality of life, interventions should focus on early diagnosis, access to standard chemotherapy regimens, and post-treatment care.