Clinical features and prognosis of elderly patients with cytogenetically normal acute myeloid leukemia
10.3760/cma.j.issn.1009-9921.2017.03.009
- VernacularTitle:老年正常核型急性髓系白血病患者临床特征及预后分析
- Author:
Zhizhi ZHANG
;
Weimin WANG
;
Feifei WU
;
Silin GAN
;
Jie MA
;
Yanfang LIU
;
Xinsheng XIE
;
Ling SUN
;
Dingming WAN
;
Zhongxing JIANG
;
Hui SUN
- Keywords:
Leukemia;
myeloid;
acute;
Elderly;
Normal karyotype;
Prognosis
- From:
Journal of Leukemia & Lymphoma
2017;26(3):161-165
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics and prognostic factors of elderly patients with cytogenetically normal acute myeloid leukemia (CN-AML). Methods A total of 104 initial CN-AML patients were enrolled in this retrospective study. The clinical characteristics were collected and analyzed retrospectively. Factors affecting complete remission (CR) were analyzed by using chi square test. Univariate and multivariate analyses of prognostic factors were performed by using Kaplan-Meier and Cox hazard regression model respectively. Results After the first chemotherapy, 72 of 104 patients were able to be evaluated the efficacy, the CR rate was 38.9%(28/72) and total response rate was 55.6%(40/72). The white cell count<100 × 109/L and NPM1 mutation were related to a higher CR rate [59.4%(38/64) vs. 12.5%(1/8), 83.3%(10/12) vs. 36.4%(8/22), P<0.05]. Among 104 patients, the median overall survival (OS) was 6.9 months. Univariate analysis results demonstrated that age≥70 years, secondary AML, white cell count≥100×109/L, FLT3-ITD mutation, CD7 expression, achieving CR beyond 2 cycles of induction therapy and CCI score≥2 were influence factors on OS. In multivariable analysis, FLT3-ITD mutation (HR=7.61, 95%CI 1.80-32.11, P= 0.006) and achieving CR beyond 2 cycles of induction therapy (HR= 10.11, 95 % CI 2.38-43.03, P=0.002) were independent prognostic factors for OS in elderly patients with CN-AML. Conclusion The prognosis of elderly patients with CN-AML is the result of the combined effect of many factors, FLT3-ITD mutation and achieving CR beyond 2 cycles of induction therapy are independent prognostic factors in elderly patients with CN-AML.
