Efficacy and prognosis analysis of chemotherapy regimens including decitabine in treatment of newly elderly patients with acute myeloid leukemia
10.3760/cma.j.issn.1009_9921.2019.04.004
- VernacularTitle:含地西他滨化疗方案治疗初治老年人急性髓系白血病效果及预后分析
- Author:
Huanhuan TIAN
1
;
Yuying LI
;
Jingnan SUN
;
Long SU
;
Hai LIN
;
Yehui TAN
;
Sujun GAO
Author Information
1. 吉林大学第一医院肿瘤中心血液科
- Keywords:
Leukemia,myeloid,acute;
Aged;
Antineoplastic combined chemotherapy protocols;
Treatment outcome;
Prognosis;
Decitabine
- From:
Journal of Leukemia & Lymphoma
2019;28(4):210-214
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and prognostic factors of chemotherapy regimens including decitabine in treatment of elderly patients newly diagnosed with acute myeloid leukemia (AML). Methods The clinical data of 47 elderly patients newly diagnosed with AML (except M3) who received chemotherapy regimens including decitabine in the First Hospital of Jilin University from February 2013 to November 2017 were retrospectively analyzed, including 11 patients treated with single decitabine and 36 patients treated with decitabine combined with low_dose chemotherapy group. The treatment outcome and the impact of different factors on the prognosis were also analyzed. Results Of 47 patients, there were 15 males and 32 females, and the median age was 65 years old (60-83 years old). The overall response rate of decitabine plus low_dose chemotherapy group for 1 course was higher than that of single decitabine group [80.6% (26/36) vs. 27.3% (3/11), χ 2 ＝ 8.693, P＝ 0.003], and the former showed less courses to acquire remission than the latter (u＝ 3.133, P＝ 0.002); however, there was no significant difference in the median overall survival (OS) time between the two groups (14 months vs. 12 months, P＝ 0.950). Univariate analysis indicated that the median OS time in the complete remission (CR) group was longer than that in the non_CR group (17 months vs. 5 months, P <0.01). The median OS time of the elderly patients with primary AML was longer than that of the patients with secondary AML (16 months vs. 6 months, P＝ 0.01). Cox multifactor analysis showed that failing to achieve CR was identified as an independent adverse influencing factor ( HR＝0.180, 95% CI 0.085-0.382, P< 0.01). The incidence of neutropenia with fever in the patients treated with decitabine plus low_dose chemotherapy group was higher than that in single decitabine group [69.4% (25/36) vs. 36.4% (4/11), χ2＝3.902, P＝0.048]. Conclusion For newly elderly AML patients, chemotherapy regimens including decitabine are safe and effective.
