Analysis of clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia(AML).Methods Clinical data of 232 patients with acute myelocytic leukemia(AML,except for acute promyelocytic leukemia) admitted in our hospital from January 2012 to December 2015 were retrospectively analyzed.Factors affecting complete remission (CR) were analyzed by using x2 test,and Kaplan-Meier survival analysis was conducted.Univariate and multivariate analysis of prognostic factors were performed by using Log-Rank test and Cox regression model respectively.Results Of 232 patients,195 patients received induction chemotherapy,among whom 8 patients died in early phase,efficacy could not be evaluated in 25 cases,with 162 patients for final statistical study.The CR rate was 37.0％ (60/162) after the first therapy course,and overall CR rate was 54.9％ (89/162).Thirty-seven patients received palliative treatment,among whom 6 patients died in early phase and none achieved CR.Therefore,the 162 patients receiving an induction chemotherapy,whose efficacy can be evaluated,could be clinically analyzed.They were in 60-69 years old (x2 =4.102,P =0.043),with ECOG score≤ 2 (x2 =9.917,P =0.002),NPM1 +FLT3-ITD-(x2 =6.423,P =0.038),favorable karyotypes(x2 =6.033,P =0.049),and related to a higher CR rate.The median overall survival(OS) was 205 days in the 232 patients.Univariate analysis results demonstrated that age(x2 =8.700,P =0.003),white blood cell (WBC) count ≥ 100 × 109/L (x2=4.249,P=0.039),karyotypes(x2=4.807,P=0.028),palliative treatment(x2 =191.221,P=0.000) were influencing factors for the prognosis.Multivariable analysis showed that age(HR =0.464,95％CI0.245-0.877,P =0.018),karyotypes(HR =3.618,95％CI1.491-6.728,P =0.003) and whether or not to receive induction chemotherapy (HR =0.076,95 ％ CI0.030-0.194,P =0.000) were independent influencing factors for OS in elderly patients with AML.Conclusions The prognosis of elderly patients with AML is affected by multiple factors.Age,karyotypes and whether or not to receive induction chemotherapy are independent influencing factors for OS in elderly patients with AML.