Easily manageable prognostic factors in 152 Chinese elderly acute myeloid leukemia patients: a single-center retrospective study
Open Access
- 1 January 2014
- journal article
- Published by Journal of Biomedical Research in Journal of Biomedical Research
- Vol. 28 (5), 396-405
- https://doi.org/10.7555/jbr.28.20130164
Abstract
We retrospectively investigated the prognostic factors of acute myeloid leukemia (AML) in 152 Chinese patients with de novo AML who were older than 60 years of age and who received treatment at our hospital. Log-rank test showed that 6 parameters including older age, higher white blood cell (WBC) counts, lactate dehydrogenase (LDH) and bone marrow (BM) blasts at diagnosis, unfavorable risk cytogenetics, and non-mutated CEBPα were significant adverse prognostic factors of overall survival (OS) for elderly AML patients (P = 0.0013, 0.0358, 0.0132, 0.0242, 0.0236 and 0.0130, respectively). Moreover, older age and higher LDH were significant adverse predictors for relapse-free survival (RFS) (P = 0.0447 and 0.0470, respectively). Univariate analysis revealed similar results for OS to those of the log-rank test and only higher LDH at diagnosis was a significant adverse predictor for RFS (P = 0.028, HR: 1.979, 95%CI: 1.075–3.644). In multivariate analysis, we identified 2 trends towards independent prognostic factors for OS, including BM blasts at diagnosis (P = 0.057, HR: 1.676, 95%CI: 0.984–2.854) and mutation status of CEBPα (P = 0.064, HR: 4.173, 95%CI: 0.918–18.966). Our data indicated that older age, gender and a previous history of hematologic diseases resulted in lower complete remission rate (P = 0.012, 0.051 and 0.086, respectively). We further developed an easy scoring system for predicting prognosis and response to induction therapy in older AML patients. Patients who had lower scores showed significantly longer OS and RFS (P = 0.0006 and 0.1001, respectively) and higher CR rate (P = 0.014). Our research is limited by its retrospective nature and the results from our study need to be further validated by prospective randomized clinical trials.Keywords
This publication has 29 references indexed in Scilit:
- Geriatric assessment in older patients with acute myeloid leukemia: A retrospective study of associated treatment and outcomesLeukemia Research, 2013
- Acute myeloid leukemia: 2013 update on risk‐stratification and managementAmerican Journal of Hematology, 2013
- Targeting Age-Related Changes in the Biology of Acute Myeloid Leukemia: Is the Patient Seeing the Progress?Interdisciplinary topics in gerontology, 2013
- Prognostic risk score for the survival of elderly patients with acute myeloid leukaemia comprising comorbiditiesMedical Oncology, 2012
- Acute myeloid leukemia in older adultsInternational Journal of Hematology, 2012
- Acute myeloid leukemia in the real world: why population-based registries are neededBlood, 2012
- Treatment of acute myeloid leukemia: are we making progress?Hematology, 2012
- Treatment of Unfit Patients With Acute Myeloid Leukemia: A Still Open Clinical ChallengeClinical Lymphoma Myeloma and Leukemia, 2011
- Acute Myeloid Leukemia in the Elderly: Assessment of Multidrug Resistance (MDR1) and Cytogenetics Distinguishes Biologic Subgroups With Remarkably Distinct Responses to Standard Chemotherapy. A Southwest Oncology Group StudyBlood, 1997
- Estimate of overall treatment results in acute nonlymphocytic leukemia based on age-specific rates of incidence and of complete remission.1985