CubaPLUS Magazine

Acute Myeloid Leukemia (AML) in adults is a type of cancer in which the bone marrow produces excessive amounts of abnormal blood cells, interfering with the normal production of red blood cells, white blood cells, and platelets.
 
Like any other country, Cuba is not exempt from having patients affected by this disease. For this reason, the Institute of Hematology and Immunology conducted a retrospective cohort study between January 2013 and December 2019 to evaluate predictive response factors based on the doses of daunorubicin (DNR) administered.

According to Dr. Yamilé Quintero Sierra, a First- and Second-Degree Specialist in Hematology, the study included 85 patients divided into two groups. One group of 56 patients received high doses of daunorubicin, while the second group of 29 patients received the standard DNR dose.
 
In the high-dose group, significant findings were observed across clinical, biochemical, immunological, and molecular variables. The identified predictors of Complete Remission (CR) included an ECOG score below two, normal creatinine levels, the presence of the NPM1 mutation, and positive expression of CD33 and CD34 antigens in myeloid blasts.

In the standard-dose group, the predictive factor was the positive expression of the CD33 antigen. The study results indicated that the overall survival predictors were Complete Remission, normal levels of aspartate aminotransferase (AST), the presence of the RUNX1-RUNX1T1 mutation, and the positive expression of the CD4 antigen—showing a higher probability of survival in the high-dose group.
 
The treatment regimen consists of chemotherapy combining an anthracycline for three days with cytarabine (Ara-C) for seven days, a protocol known as “3+7.” This standardized approach is used for adult patients under 60 years old with non-promyelocytic AML. This regimen achieves CR rates of 60–80%, both internationally and in Cuba, where daunorubicin is the most commonly used anthracycline.

Dr. Quintero Sierra highlighted that this was the first study conducted in Cuba to identify multiple factors related to the diagnosis and progression of the disease, marking a significant advancement in hematologic research within the country.

From a theoretical standpoint, the study demonstrates the role of immunological, cytogenetic, and molecular factors in disease prognosis and underscores the need to develop treatment protocols tailored to these factors while adapting them to the country’s conditions.

Practically, this allows for the implementation of treatment protocols with a more precise prognostic approach tailored to the Cuban population. This contributes to improved therapeutic outcomes, increases the number of survivors with lower relapse rates, and provides clinical, biochemical, immunological, cytogenetic, and molecular tools for further AML research in Cuba.

Socially, this approach enhances specialized care for patients with non-promyelocytic AML, enabling better reintegration into society and an improved quality of life. By identifying factors that influence treatment response, the study optimizes both human and material resources for the benefit of patients, Dr. Quintero Sierra concluded.