ArticleInternational journal of hematology2026
Incidence, etiology, and predictors of early mortality after induction chemotherapy for aml in a middle-income country.
Article in International journal of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEarly mortality (EM) in acute myeloid leukemia (AML) represents a significant challenge in middle-income countries. This study determined the 30-day and 60-day EM rates and identified independent prognostic factors at a Peruvian national reference center.
methodsRetrospective cohort of 139 adults treated with 7 + 3 induction chemotherapy at the Hospital Nacional Edgardo Rebagliati Martins (2020-2024). Cox proportional hazards models were used to estimate adjusted hazard ratios (aHR).
resultsThe 30-day and 60-day EM rates were 17.3% (24 deaths) and 24.5% (34 deaths), respectively, 79.4% of deaths were of infectious etiology. ICU admission was the strongest predictor of 30-day mortality (aHR 12.88; 95% CI 4.87-34.08), with a time-dependent effect attenuating beyond day 21. The post-induction complete remission (CR) rate was 54.0%; patients achieving CR had markedly superior survival (log-rank p < 0.001). Age ≥ 60 years was not an independent predictor of early death.
conclusionsEarly mortality substantially exceeds European benchmarks, driven primarily by infectious complications and clinical severity at presentation. ICU admission is a critical prognostic indicator; chronological age should not preclude intensive induction therapy.
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