---
title: "Early Induction Outcomes and Predictors in Acute Myeloid Leukemia (non-APL): A Cohort Study"
id: "pubmed-42664133"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42664133"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42664133/"
doi: "10.7417/CT.2026.2113"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Early Induction Outcomes and Predictors in Acute Myeloid Leukemia (non-APL): A Cohort Study
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42664133
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42664133/)
- **DOI:** [10.7417/CT.2026.2113](https://doi.org/10.7417%2FCT.2026.2113)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This observational cohort study evaluated **day-28 induction outcomes** in 90 adults with newly diagnosed non-APL acute myeloid leukemia (AML) treated with induction chemotherapy at Al-Azhar University Hospitals, Cairo, Egypt (Jan 2020–Dec 2024). - Outcomes were categorized as complete remission (CR), refractory disease (R), or induction-related death (IID); an unfavorable induction outcome was defined as R or IID. - Results: 53/90 (58.9%) achieved **CR**, 20/90 (22.2%) had refractory disease, and 17/90 (18.9%) experienced **IID**. - Poor baseline performance status (ECOG ≥2) was significantly associated with unfavorable induction outcomes on univariate (OR 4.58) and multivariate (OR 3.96) analyses. - Severe thrombocytopenia (<50 ×10^3/µL) and higher peripheral blood blast burden were associated with worse induction outcomes in univariate analysis. - The study collected demographic, clinical, laboratory, infectious, comorbidity, immunophenotypic, and cytogenetic variables and applied univariate and multivariate logistic regression to identify predictors. - The abstract reports that data on other specific comorbidity, infectious complication, immunophenotype, and cytogenetic associations were incompletely reported in the source; details beyond the items above were not provided in the available text. - The study emphasizes challenges in low- and middle-income settings (delayed diagnosis, limited supportive care, treatment-related complications) as background context for suboptimal induction outcomes. - Full-text details (exact induction regimens, supportive-care measures, definitions for infectious complications, full multivariate model covariates, and additional statistical results) were not reported in the abstract available on PubMed.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42664133/#linkout) Title & authors Abstract Similar articles Publication types MeSH terms LinkOut - more resources Observational Study Clin Ter Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Ter%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Ter%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42664133/) . 2026 Sep-Oct;177(5):1117-1130. doi: 10.7417/CT.2026.2113. # Early Induction Outcomes in Acute Myeloid Leukemia: Impact of Clinical Status, Infectious Complications, Cardiometabolic Comorbidities, and Diagnostic Features in a Cohort Study [Ahmed Akef](https://pubmed.ncbi.nlm.nih.gov/?term=Akef+A&cauthor_id=42664133)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-1 "Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt."), [Maysa Aly](https://pubmed.ncbi.nlm.nih.gov/?term=Aly+M&cauthor_id=42664133)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-2 "Faculty of Medicine, Cairo University, Cairo, Egypt."), [Mohamed Hanafy Morsy](https://pubmed.ncbi.nlm.nih.gov/?term=Morsy+MH&cauthor_id=42664133)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-3 "Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Ola Abd Elfattah Ali Amro](https://pubmed.ncbi.nlm.nih.gov/?term=Amro+OAEA&cauthor_id=42664133)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-4 "Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Fatma M Elsayed](https://pubmed.ncbi.nlm.nih.gov/?term=Elsayed+FM&cauthor_id=42664133)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-5 "Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt."), [Heba Yahia Elkholy](https://pubmed.ncbi.nlm.nih.gov/?term=Elkholy+HY&cauthor_id=42664133)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-6 "Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt."), [Murad Barakat](https://pubmed.ncbi.nlm.nih.gov/?term=Barakat+M&cauthor_id=42664133)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-7 "Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Loai Emam](https://pubmed.ncbi.nlm.nih.gov/?term=Emam+L&cauthor_id=42664133)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-3 "Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Amira N Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+AN&cauthor_id=42664133)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-8 "Clinical and Chemical Pathology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt."), [Lama M El-Attar](https://pubmed.ncbi.nlm.nih.gov/?term=El-Attar+LM&cauthor_id=42664133)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-9 "Human Genetics Department, Medical Research Institute, Alexandria University, Egypt."), [Peter Makram Thabet Matta](https://pubmed.ncbi.nlm.nih.gov/?term=Matta+PMT&cauthor_id=42664133)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-10 "Department of Emergency Medicine, Faculty of Medicine, Assiut University, Egypt."), [Salwa M Abdelhamid](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelhamid+SM&cauthor_id=42664133)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-11 "Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt."), [Walid Mohamed Kamel Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+WMK&cauthor_id=42664133)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-12 "Department of Critical Care Medicine, Faculty of Medicine, Cairo University Cairo, Egypt."), [Eiman Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+E&cauthor_id=42664133)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-13 "Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia."), [Neveen Shalaby](https://pubmed.ncbi.nlm.nih.gov/?term=Shalaby+N&cauthor_id=42664133)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#full-view-affiliation-14 "Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Tanta University, Egypt.") Affiliations Expand ### Affiliations * 1 Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. * 2 Faculty of Medicine, Cairo University, Cairo, Egypt. * 3 Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 4 Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 5 Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt. * 6 Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt. * 7 Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 8 Clinical and Chemical Pathology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. * 9 Human Genetics Department, Medical Research Institute, Alexandria University, Egypt. * 10 Department of Emergency Medicine, Faculty of Medicine, Assiut University, Egypt. * 11 Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. * 12 Department of Critical Care Medicine, Faculty of Medicine, Cairo University Cairo, Egypt. * 13 Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia. * 14 Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Tanta University, Egypt. * PMID: **42664133** * DOI: [ 10.7417/CT.2026.2113 ](https://doi.org/10.7417/ct.2026.2113) Free article Item in Clipboard Observational Study # Early Induction Outcomes in Acute Myeloid Leukemia: Impact of Clinical Status, Infectious Complications, Cardiometabolic Comorbidities, and Diagnostic Features in a Cohort Study Ahmed Akef et al. Clin Ter. 2026 Sep-Oct. Free article Show details Display options Display options Format Abstract PubMed PMID Clin Ter Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Ter%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Ter%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42664133/) . 2026 Sep-Oct;177(5):1117-1130. doi: 10.7417/CT.2026.2113. ### Authors [Ahmed Akef](https://pubmed.ncbi.nlm.nih.gov/?term=Akef+A&cauthor_id=42664133)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-1 "Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt."), [Maysa Aly](https://pubmed.ncbi.nlm.nih.gov/?term=Aly+M&cauthor_id=42664133)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-2 "Faculty of Medicine, Cairo University, Cairo, Egypt."), [Mohamed Hanafy Morsy](https://pubmed.ncbi.nlm.nih.gov/?term=Morsy+MH&cauthor_id=42664133)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-3 "Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Ola Abd Elfattah Ali Amro](https://pubmed.ncbi.nlm.nih.gov/?term=Amro+OAEA&cauthor_id=42664133)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-4 "Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt."), [Fatma M Elsayed](https://pubmed.ncbi.nlm.nih.gov/?term=Elsayed+FM&cauthor_id=42664133)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-5 "Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt."), [Heba Yahia Elkholy](https://pubmed.ncbi.nlm.nih.gov/?term=Elkholy+HY&cauthor_id=42664133)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-6 "Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt."), [Murad Barakat](https://pubmed.ncbi.nlm.nih.gov/?term=Barakat+M&cauthor_id=42664133)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-7 "Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Loai Emam](https://pubmed.ncbi.nlm.nih.gov/?term=Emam+L&cauthor_id=42664133)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-3 "Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Amira N Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+AN&cauthor_id=42664133)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-8 "Clinical and Chemical Pathology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt."), [Lama M El-Attar](https://pubmed.ncbi.nlm.nih.gov/?term=El-Attar+LM&cauthor_id=42664133)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-9 "Human Genetics Department, Medical Research Institute, Alexandria University, Egypt."), [Peter Makram Thabet Matta](https://pubmed.ncbi.nlm.nih.gov/?term=Matta+PMT&cauthor_id=42664133)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-10 "Department of Emergency Medicine, Faculty of Medicine, Assiut University, Egypt."), [Salwa M Abdelhamid](https://pubmed.ncbi.nlm.nih.gov/?term=Abdelhamid+SM&cauthor_id=42664133)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-11 "Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt."), [Walid Mohamed Kamel Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+WMK&cauthor_id=42664133)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-12 "Department of Critical Care Medicine, Faculty of Medicine, Cairo University Cairo, Egypt."), [Eiman Ibrahim](https://pubmed.ncbi.nlm.nih.gov/?term=Ibrahim+E&cauthor_id=42664133)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-13 "Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia."), [Neveen Shalaby](https://pubmed.ncbi.nlm.nih.gov/?term=Shalaby+N&cauthor_id=42664133)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42664133/#short-view-affiliation-14 "Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Tanta University, Egypt.") ### Affiliations * 1 Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. * 2 Faculty of Medicine, Cairo University, Cairo, Egypt. * 3 Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 4 Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * 5 Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt. * 6 Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt. * 7 Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 8 Clinical and Chemical Pathology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. * 9 Human Genetics Department, Medical Research Institute, Alexandria University, Egypt. * 10 Department of Emergency Medicine, Faculty of Medicine, Assiut University, Egypt. * 11 Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. * 12 Department of Critical Care Medicine, Faculty of Medicine, Cairo University Cairo, Egypt. * 13 Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia. * 14 Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Tanta University, Egypt. * PMID: **42664133** * DOI: [ 10.7417/CT.2026.2113 ](https://doi.org/10.7417/ct.2026.2113) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Induction chemotherapy outcomes in acute myeloid leukemia (AML) remain suboptimal in many low- and middle-income countries due to delayed diagnosis, limited supportive care resources, and treatment-related complications. Data regarding predictors of induction outcomes in resource-limited settings remain scarce. This study aimed to evaluate day-28 induction outcomes and identify clinical, laboratory, infectious, comorbidity-related, and diagnostic factors associated with unfavorable induction outcomes in adult AML patients. **Methods:** This observational cohort study included 90 adult patients with newly diagnosed non-acute promyelocytic leukemia (non-APL) AML who received induction chemotherapy between January 2020 and December 2024 at Al-Azhar University Hospitals, Cairo, Egypt. Day-28 induction outcomes were categorized as complete remission (CR), refractory disease (R), or induction-related death (IID). Unfavorable induction outcome was defined as refractory disease or IID. Baseline demographic, clinical, laboratory, infectious, comorbidity, immunophenotypic, and cytogenetic variables were analyzed using univariate and multivariate logistic regression models. **Results:** Among the 90 patients, 53 (58.9%) achieved CR, 20 (22.2%) had refractory disease, and 17 (18.9%) experienced IID. Poor ECOG performance status (≥2) was significantly associated with unfavorable induction outcomes in both univariate (OR = 4.58, 95% CI: 1.74 - 12.08, P = 0.002) and multivariate analyses (OR = 3.96, 95% CI: 1.39 - 11.27, P = 0.010). Severe thrombocytopenia (<50 ×10³/μL) and higher peripheral blood blast burden were also associated with poorer induction outcomes on univariate analysis. Patients with comorbiditi
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