ABSTRACT Background: Despite important advances in the ther- apy of acute myeloid leukemia (AML), the majority of patients die of their disease, unless bone marrow trans- plantation (BMT) is done. Infection and hemorrhage are still the major causes of mortality in AML patients. Progress in therapy and supportive care has led to gradual improve- ment in the overall results, but further improvements are still needed. Patients and Methods: The aim of this study is to identify the outcome and costs of adult AML patients treated with conventional chemotherapy (CCT) at the National Cancer Institute (NCI), Cairo University during the time period from April 1999 to January 2002. Clinical, laboratory characteristics were all recorded. Data regarding different types of therapies given for these patients includ- ing response, outcome and costs were also collected. Results: The median age of 82 identified AML patients was 34 years. The complete remission (CR) rate after induction with CCT was 52% (42/82 patients) with a median CR duration of 9 months. Twenty-eight percent of patients who achieved CR subsequently relapsed. By January 2003, fifty-eight patients were dead (70.7%). Infections were the major mortality cause, followed by disease progression then bleeding (65%, 28% and 7% respectively). The median treatment cost per patient was 33158 Egyptian Pounds (LE). It was higher for patients who achieved CR compared to those who relapsed and/or died. Drugs contributed by 78 % to the total treatment cost, while hospitalization, investigations and blood-component therapy contributed by 6%, 7% and 8% respectively. Conclusions: Outcome of patients with AML treated at NCI- Cairo University can be enhanced by improvement of supportive therapy; mainly infection control and ex- panding BMT programs to accommodate all eligible patients. Journal of the Egyptian Nat. Cancer Inst., Vol. 19, No. 2, June: 106-113, 2007 Cost and Outcome of Treatment of Adults with Acute Myeloid Leukemia at the National Cancer Institute-Egypt HEBA M. EL-ZAWAHRY, M.D.*; AHMED A. ZEENELDIN, M.D.*; MOHAMED A. SAMRA, M.D.*; MERVAT M. MATTAR**; MOSAAD M. EL-GAMMAL, M.Sc.*; AYMAN ABD EL-SAMEE, M.D.* and TAREK DARWISH, M.D.* The Department of Medical Oncology*, National Cancer Institute, Cairo University and the Department of Internal Medicine, Faculty of Medicine, Cairo University**. 106 Key Words: AML – Chemotherapy – Mortality – Cost – Outcome – NCI – Egypt. INTRODUCTION Even though generally considered as an illness of the developed countries, cancer is a world-wide health problem. In the year 2000, 54% of new cancer cases occurred in developing countries [1]. In USA, acute myeloid leukemia (AML) constituted 13410 out of 1444920 (0.9%) new cancer cases diagnosed in 2007. AML led to death in 8990 out of 559650 total cancer deaths [2]. In the National Cancer Institute (NCI) Cairo University during the year 2002, out of a total of 19405 new cancer cases, 169 patients (1.8%) were diagnosed as AML [3]. AML represents a group of clonal hemato- poietic stem cell disorders in which both failure to differentiate and over-proliferation of the stem cell compartment result in accumulation of non-functional myeloblasts, impaired hemato- poiesis and cytopenias. While the specific cause in any individual patient is usually unknown, the growing understanding of the genetic back- grounds of leukemia is beginning to lead to a wide array of targeted therapies [4]. French-American-British (FAB) classifica- tion remains useful in identifying certain bio- logic subtypes but does not account for all subtypes. More recently, the diagnosis and prognosis of AML is based not only on the FAB classification, but also on cytogenetics, immu- nophenotyping (IPT) and molecular genetics. Such advances have led to a new World Heath Organization (WHO) classification that attempts to correlate morphology, cytochemistry, immu- Correspondence: Dr Mohamed A. Samra, National Cancer Institute, Fom El Khalig Square, Cairo, abdelmooti@ hotmail.com