Easily manageable prognostic factors in 152 Chinese elderly acute myeloid leukemia patients:a single-center retrospective study

作     者：Jiadai Xu Tingmei Chen Yun Liu Huayuan Zhu Wei Wu WenYi Shen Bei Xu Sixuan Qian Jianyong Li Peng Liu 

作者机构：Department of Hematologythe First Affiliated Hospital of Nanjing Medical University Department of Clinical Oncologythe First Affiliated Hospital of Nanjing Medical University 

出 版 物：《The Journal of Biomedical Research》 (生物医学研究杂志（英文版）)

年 卷 期：2014年第28卷第5期

页      面：396-405页

学科分类：0710[理学-生物学] 1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by National Natural Science Foundation of China(No.81170486,81170485 and 81101498) Natural Science Fund for Distinguished Young Scholars of Jiangsu Province(BK20130049) Scientific Research Foundation from the Ministry of Education of China(43-NJYKDX-3) Jiangsu Province's Medical Elite Program(RC2011168) Key Project of Jiangsu Province Health Agency(K201107) "Liu Da Ren Cai Gao Feng"Project(2012-WS-017) A Project funded by the Priority Academic Program Development of Jiangsu Higher Education Institute(JX10231801) 

主　　题：acute myeloid leukemia elderly patients prognosis factors 

摘      要：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 ***-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 *** 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.