The prognostic effects of two comprehensive geriatric assessment methods in elderly patients with acute myeloid leukemia
10.3760/cma.j.cn112138-20201029-00904
- VernacularTitle:两种老年综合评估方法在老年急性髓系白血病中评价预后价值的比较
- Author:
Shuai ZHANG
1
;
Ru FENG
;
Jiangtao LI
;
Ting WANG
;
Chunli ZHANG
;
Jiefei BAI
;
Yao LI
;
Rongyan SHAO
;
Hui LIU
Author Information
1. 北京医院血液内科 国家老年医学中心 中国医学科学院老年医学研究院 100730
- Keywords:
Aged;
Leukemia, myeloid, acute;
Comprehensive geriatric assessment
- From:
Chinese Journal of Internal Medicine
2021;60(10):880-885
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognostic effects of two comprehensive geriatric assessment (CGA) methods in elderly patients with acute myeloid leukemia (AML).Methods:Ninety-seven patients with newly diagnosed AML at Beijing Hospital from August 2008 to December 2019 were included (≥60 years old). All patients were evaluated by two methods of CGA. One was IACA index proposed by Beijing Hospital, including instrumental activities of daily living (IADL), age, Charlson comorbidity index (CCI), albumin; the other was proposed by Italian FIL study group (FIL-CGA), including activities of daily living (ADL), IADL, age, and modified cumulative illness rating score for geriatrics (MCIRS-G).Results:Among 97 patients, 54 patients received standard chemotherapy, 16 with decitabine, 2 with targeted therapy and 25 with the best supportive therapy. The overall response rate (ORR) in 72 treated patients were 67.7%, 33.3% and 0 respectively in fit, unfit and frail groups according to IACA index ( P=0.001). Based on FIL-CGA, the ORRs of fit, unfit and frail groups were 52.5%, 41.7% and 35.0% respectively ( P=0.418). The 1-year OS rates of fit, unfit and frail groups regarding IACA method were 78.7%, 27.7% and 0 respectively ( P<0.01). The 1-year OS rates of fit, unfit and frail groups regarding FIL-CGA method were 67.8%, 28.2% and 13.9% respectively ( P<0.01), while no significant difference was seen between unfit group and frail group ( P=0.111). The early death rates of fit, unfit and frail groups by IACA were 0, 6.0% and 28.6% respectively ( P=0.006), while those by FIL-CGA were 2.3%, 5.9%, 13.9% respectively ( P=0.123). Conclusion:Compared with FIL-CGA method, IACA predicts more effectively the treatment response, survival and early mortality in elderly patients with AML.
