Preliminary study of HCT-CI score system for prognosis prediction in elderly patients with acute myeloid leukemia after chemotherapy.
- Author:
Jie SHI
1
;
Yin ZHANG
;
Bao-gen MA
;
Kai SUN
;
Ping-chong LEI
;
Zun-min ZHU
;
Yu-zhu ZANG
;
Yu-qing CHEN
;
Jian-min GUO
;
Jing YANG
;
Zhong-wen LIU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Aged, 80 and over; Female; Hematopoietic Stem Cell Transplantation; adverse effects; Humans; Leukemia, Myeloid, Acute; diagnosis; Male; Middle Aged; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Treatment Outcome
- From: Chinese Journal of Hematology 2013;34(1):8-11
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the value of the HCT-CI score in chemotherapy risk assessment and prognosis of elderly patients with acute myeloid leukemia (AML).
METHODSThe clinical data of 116 AML patients older than 60 years in the department of Hematology, Henan Provincial People's Hospital from January 2000 to December 2010 were analyzed retrospectively. All patients received cytarabine-based regimens, including protocol DA, MA, IA, AA or CAG, followed by cytarabine-based postremission treatment. (1) Comorbidities were evaluated by using HCT-CI score, the early death rates and median survival time were compared among these different groups. (2) These prognostic factors were analyzed by univariate and multivariate analyses.
RESULTS(1) All 116 cases were followed-up. The patient cohort was divided into those with HCT-CI scores of 0, 1 or 2, or ≥ 3. Early death rates were 3.7%, 12.1% and 23.21% in above three groups, respectively (P < 0.01). Overall survival were 345, 225 and 113 days, respectively (P < 0.01). (2) HCT-CI score ≥ 3 (P < 0.01), antecedent MDS history (P = 0.035), high-risk karyotype (P = 0.018), white blood cells at diagnosis ≥ 100×10(9)/L (P = 0.041) were independent adverse prognostic factors with multivariate analysis.
CONCLUSION(1) The HCT-CI score can objectively assess elderly AML patients with comorbidities and predict chemotherapy risk in older patients receiving AML induction therapy. (2) Antecedent MDS history, high-risk karyotype, high white blood cell, and HCT-CI score ≥ 3 are independent adverse prognostic factors of elderly AML patients.