Epidemiology of de novo Acute Myeloid Leukemia in Kuwait per the 2016 WHO Classification

Salem H Alshemmari 1 2, Mazyad Almazyad 1, Mohan Ram 2, Liby Mariamma John 2, Ahmed Alhuraiji 2

Affiliations

01 January 2022

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doi: 10.1159/000524641

Abstract

Objective: Acute myeloid leukemia (AML) is a hematological malignancy that arises from the clonal proliferation of immature myeloid cells. Although the number of AML cases has dramatically increased worldwide, information on its prevalence and incidence in Kuwait is lacking. This study reports the incidence of AML and patient demographics in the country from 2014 to 2020, based on the 2016 WHO classification of AML.

Subjects and methods: Data on patients with AML, including acute promyelocytic leukemia (APL), were collected from a clinical cohort with 281 cases analyzed in this study.

Results: The overall median age of the population was 47 years with a 1.1:1 male-to-female ratio. Over the study period, the incidence of AML demonstrated a general increasing trend, with the highest and lowest overall incidence occurring in 2018 and 2015, respectively. The frequency of APL in our cohort was 8.9%. Regarding the 2017 European LeukemiaNet (ELN) risk stratification of patients with AML, 37%, 46%, and 17% of patients had a favorable, intermediate, and adverse risk, respectively. A total of 57% of cases achieved complete remission post-induction, and the median overall survival was 37 months.

Conclusion: Our study may help predict the future trends of AML in Kuwait to help improve clinical management and patient outcomes.

Keywords: Acute myeloid leukemia; Epidemiology; Incidence; Kuwait.

Conflict of interest statement

The authors have no conflicts of interest to declare.

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References

  1.  
    1. Short NJ, Rytting ME, Cortes JE. Acute myeloid leukaemia. Lancet. 2018 Aug 18;392((10147)):593–606. - PubMed
  2.  
    1. Soignet SL, Maslak P, Wang ZG, Jhanwar S, Calleja E, Dardashti LJ, et al. Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide. N Engl J Med. 1998 Nov 5;339((19)):1341–8. - PubMed
  3.  
    1. Grimwade D. Impact of cytogenetics on clinical outcome in AML. In: Karp JE, editor. Acute myelogenous leukemia. Totowa, NJ: Humana Press; 2007. pp. p. 177–92.
  4.  
    1. Freeman SD, Jovanovic JV, Grimwade D. Development of minimal residual disease-directed therapy in acute myeloid leukemia. Semin Oncol. 2008 Aug;35((4)):388–400. - PubMed
  5.  
    1. Horner M, Ries L, Krapcho M, Neyman N, Aminou R, Howlader N, et al. SEER cancer statistics review. Bethesda, MD: National Cancer Institute; 1975.
  6.  
    1. Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, et al. SEER cancer statistics review, 1975–2016 . Bethesda, MD: National Cancer Institute; 2019. Apr, Based on November 2018 SEER data submission, posted to the SEER web site. Available from: https://seer.cancer.gov/csr/1975_2016/
  7.  
    1. Prevention Global Coalition to Fight Financial Crime Ten-year cancer incidence among nationals of the GCC states (1998–2007) 2011.
  8.  
    1. Kingdom of Saudi Arabia Saudi Health Council Saudi Cancer Registry 2014 CIRSA. 2017 Sep
  9.  
    1. Younis M, Al-Hajeri M, Celik Y, Kisa A, Richard P, Parkash J. Healthcare of aging population of Kuwait. Ageing Int. 2015;40((1)):36–43.
  10.  
    1. Al-Bahar S, Pandita R, al-Muhannaha A, Al-Bahar E. The epidemiology of leukemia in Kuwait. Leuk Res. 1994 Apr;18((4)):251–5. - PubMed
  11.  
    1. Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017 Jan 26;129((4)):424–47. - PMC - PubMed
  12.  
    1. De Bel-Air F. The demographic and economic framework of migration in Kuwait. Migration Policy Centre. 2013 Available from: http://hdl.handle.net/1814/32155.
  13.  
    1. Song X, Peng Y, Wang X, Chen Y, Jin L, Yang T, et al. Incidence, survival, and risk factors for adults with acute myeloid leukemia not otherwise specified and acute myeloid leukemia with recurrent genetic abnormalities: analysis of the surveillance, epidemiology, and end results (SEER) database, 2001–2013. Acta Haematol. 2018;139((2)):115–27. - PubMed
  14.  
    1. Smith A, Howell D, Patmore R, Jack A, Roman E. Incidence of haematological malignancy by sub-type: a report from the haematological malignancy research network. Br J Cancer. 2011 Nov 22;105((11)):1684–92. - PMC - PubMed
  15.  
    1. Alabdulwahab AS, Elsayed HG, Sherisher MA, Zeeneldin A, Elbjeirami WM. AML in Saudi Arabia: analysis according to the European LeukaemiaNet 2017 cytogenetic classification. Clin Lymphoma Myeloma Leuk. 2020 May;20((5)):e212–20. - PubMed
  16.  
    1. Huang HH, Chen CM, Wang CY, Hsu WWY, Chen HM, Ko BS, et al. The epidemiology, treatment patterns, healthcare utilizations and costs of acute myeloid leukaemia (AML) in Taiwan. PLoS One. 2022;17((1)):e0261871. - PMC - PubMed
  17.  
    1. Gangatharan SA, Grove CS, P'ng S, O'Reilly J, Joske D, Leahy MF, et al. Acute myeloid leukaemia in Western Australia 1991-2005: a retrospective population-based study of 898 patients regarding epidemiology, cytogenetics, treatment and outcome. Intern Med J. 2013 Aug;43((8)):903–11. - PubMed
  18.  
    1. Medeiros BC, Satram-Hoang S, Hurst D, Hoang KQ, Momin F, Reyes C. Big data analysis of treatment patterns and outcomes among elderly acute myeloid leukemia patients in the United States. Ann Hematol. 2015 Jul;94((7)):1127–38. - PMC - PubMed
  19.  
    1. Dombret H, Seymour JF, Butrym A, Wierzbowska A, Selleslag D, Jang JH, et al. International Phase 3 Study of azacitidine vs conventional care regimens in older patients with newly diagnosed AML with >30% blasts. Blood. 2015 Jul 16;126((3)):291–9. - PMC - PubMed
  20.  
    1. Rego EM, Jácomo RH. Epidemiology and treatment of acute promyelocytic leukemia in latin america. Mediterr J Hematol Infect Dis. 2011;3((1)):e2011049. - PMC - PubMed
  21.  
    1. Lo-Coco F, Avvisati G, Vignetti M, Thiede C, Orlando SM, Iacobelli S, et al. Retinoic acid and arsenic trioxide for acute promyelocytic leukemia. N Engl J Med. 2013 Jul 11;369((2)):111–21. - PubMed
  22.  
    1. Coutre SE, Othus M, Powell B, Willman CL, Stock W, Paietta E, et al. Arsenic trioxide during consolidation for patients with previously untreated low/intermediate risk acute promyelocytic leukaemia may eliminate the need for maintenance therapy. Br J Haematol. 2014 May;165((4)):497–503. - PMC - PubMed
  23.  
    1. Lancet JE, Moseley A, Komrokji RS, Coutre SE, DeAngelo DJ, Tallman MS, et al. ATRA, arsenic trioxide (ATO), and gemtuzumab ozogamicin (GO) is safe and highly effective in patients with previously untreated high-risk acute promyelocytic leukemia (APL): final results of the SWOG/Alliance/ECOG S0535 trial Blood Conference: 58th Annual Meeting of the American Society of Hematology, ASH 2016 United States. 2016;128((22)) Conference start: 2016/12/03 Conference end: 2016/12/06.
  24.  
    1. Tallman MS, Andersen JW, Schiffer CA, Appelbaum FR, Feusner JH, Woods WG, et al. All-trans retinoic acid in acute promyelocytic leukemia: long-term outcome and prognostic factor analysis from the North American Intergroup protocol. Blood. 2002 Dec 15;100((13)):4298–302. - PubMed
  25.  
    1. Opatz S, Bamopoulos SA, Metzeler KH, Herold T, Ksienzyk B, Bräundl K, et al. The clinical mutatome of core binding factor leukemia. Leukemia. 2020 Jun;34((6)):1553–62. - PMC - PubMed
  26.  
    1. Surveillance, epidemiology, and end results (SEER) program 2019. Apr, https://seer.cancer.gov/statfacts/html/amyl.html .
  27.  
    1. Döhner K, Schlenk RF, Habdank M, Scholl C, Rücker FG, Corbacioglu A, et al. Mutant nucleophosmin (NPM1) predicts favorable prognosis in younger adults with acute myeloid leukemia and normal cytogenetics: interaction with other gene mutations. Blood. 2005 Dec 1;106((12)):3740–6. - PubMed
  28.  
    1. Schnittger S, Schoch C, Kern W, Mecucci C, Tschulik C, Martelli MF, et al. Nucleophosmin gene mutations are predictors of favorable prognosis in acute myelogenous leukemia with a normal karyotype. Blood. 2005 Dec 1;106((12)):3733–9. - PubMed
  29.  
    1. Shlush LI, Zandi S, Mitchell A, Chen WC, Brandwein JM, Gupta V, et al. Identification of pre-leukaemic haematopoietic stem cells in acute leukaemia. Nature. 2014 Feb 20;506((7488)):328–33. - PMC - PubMed
  30.  
    1. Papaemmanuil E, Gerstung M, Bullinger L, Gaidzik VI, Paschka P, Roberts ND, et al. Genomic classification and prognosis in acute myeloid leukemia. N Engl J Med. 2016 Jun 9;374((23)):2209–21. - PMC - PubMed

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