Sex-Associated Differences in Outcomes in Acute Myeloid Leukemia Patients Following Intense Induction Treatment: A Real-World Single Center Analysis

Abstract

Background: Acute myeloid leukemia (AML) is a challenging disease due to its aggressive nature and interindividual variability in treatment response. While sex differences in AML incidence and outcomes have been reported, the impact of sex on treatment-related toxicity remains underexplored. Methods: We retrospectively analyzed patients who received intensive chemotherapy for de novo or secondary AML at a single academic hospital between 1 January 2017 and 30 November 2021. A total of 65 patients (62% males) were included, with similar risk categories across sexes. Results: Although adverse event rates were similar, females had significantly higher rates of neutropenic colitis (100% vs. 80%, p = 0.019) after the first induction cycle. Hematological recovery after the second cycle was faster in males for neutrophils (21 vs. 28 days, p = 0.025) and thrombocytes (27 vs. 37 days, p = 0.02). Hospitalization duration was also significantly longer for females (26 days vs. 24 days, p = 0.039). The median overall survival did not differ by sex, but was significantly longer for those receiving two cycles vs. one cycle (0.5 years vs. NR) and for those <60 years old (6.1 vs. 1.0 years). Conclusions: These findings suggest sex-related differences in treatment toxicity and hospital stay length. Larger studies are needed to better understand the impact of sex on AML outcomes.