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

Xu J, Chen T, Liu Y, Zhu H, Wu W, Shen W, Xu B, Qian S, Li J, Liu P - J Biomed Res (2014)

Bottom Line: 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).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).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).

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.

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.

No MeSH data available.


Related in: MedlinePlus

The novel scoring system performed well in stratifying elderly AML patients into three risk groups(green line: good, yellow line: intermediated, red line: poor). A: OS; B: RFS.
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f04: The novel scoring system performed well in stratifying elderly AML patients into three risk groups(green line: good, yellow line: intermediated, red line: poor). A: OS; B: RFS.

Mentions: According to the results of log-rank test, univariate and multivariate analysis, we further developed a convenient five-factor scoring system. A score of 1 was assigned to female sex, age from 60 to 69 years, WBC at diagnosis ≤ 30×109/L, LDH at diagnosis ≤ 250 U/L, or BM blasts at diagnosis at 20%–50%. A score of 2 was assigned to male sex, age from 70 to 79 years, LDH at diagnosis at 250–1,000 U/L, or BM blasts at diagnosis at 50%–80%. A score of 3 was assigned to age older than 80 years, WBC at diagnosis more than 30 × 109/L, LDH at diagnosis more than 1,000 U/L, or BM blasts at diagnosis more than 80%. Table 4 shows this scoring system in a more intuitive way. As shown in Fig. 4, the novel scoring system stratified the patients into three risk groups: a score of 5 to 7, goodrisk (n  =  56); a score of 8 to 10, intermediaterisk (n  =  58); a score of 11 to 12, poorrisk (n  =  27). The median OS was 9.48 months (range, 0.13–77.30 months) for the goodrisk group, 5.30 months (0.07–58.40 months) for the intermediate risk group and 0.8 month (0.10–86.33 months) for the poor risk group, respectively. Our scoring system was shown to be a significant prognostic factor of OS for elderly AML patients (P  =  0.0006), but not for RFS (P  =  0.1001). To validate our risk score model, we tested three independent samples from other hospitals to avoid overfit and the results turned out to be good (Table 5).


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

Xu J, Chen T, Liu Y, Zhu H, Wu W, Shen W, Xu B, Qian S, Li J, Liu P - J Biomed Res (2014)

The novel scoring system performed well in stratifying elderly AML patients into three risk groups(green line: good, yellow line: intermediated, red line: poor). A: OS; B: RFS.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4197391&req=5

f04: The novel scoring system performed well in stratifying elderly AML patients into three risk groups(green line: good, yellow line: intermediated, red line: poor). A: OS; B: RFS.
Mentions: According to the results of log-rank test, univariate and multivariate analysis, we further developed a convenient five-factor scoring system. A score of 1 was assigned to female sex, age from 60 to 69 years, WBC at diagnosis ≤ 30×109/L, LDH at diagnosis ≤ 250 U/L, or BM blasts at diagnosis at 20%–50%. A score of 2 was assigned to male sex, age from 70 to 79 years, LDH at diagnosis at 250–1,000 U/L, or BM blasts at diagnosis at 50%–80%. A score of 3 was assigned to age older than 80 years, WBC at diagnosis more than 30 × 109/L, LDH at diagnosis more than 1,000 U/L, or BM blasts at diagnosis more than 80%. Table 4 shows this scoring system in a more intuitive way. As shown in Fig. 4, the novel scoring system stratified the patients into three risk groups: a score of 5 to 7, goodrisk (n  =  56); a score of 8 to 10, intermediaterisk (n  =  58); a score of 11 to 12, poorrisk (n  =  27). The median OS was 9.48 months (range, 0.13–77.30 months) for the goodrisk group, 5.30 months (0.07–58.40 months) for the intermediate risk group and 0.8 month (0.10–86.33 months) for the poor risk group, respectively. Our scoring system was shown to be a significant prognostic factor of OS for elderly AML patients (P  =  0.0006), but not for RFS (P  =  0.1001). To validate our risk score model, we tested three independent samples from other hospitals to avoid overfit and the results turned out to be good (Table 5).

Bottom Line: 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).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).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).

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.

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.

No MeSH data available.


Related in: MedlinePlus