Robak T, Szmigielska-Kapłon A, Wrzesień-Kuś A, Wierzbowska A, Skotnicki A B, Piatkowska-Jakubas B, Kuliczkowski K, Mazur G, Zduńczyk A, Stella-Hołowiecka B, Hołowiecki J, Dwilewicz-Trojaczek J, Madry K, Dmoszyńska A, Cioch M
Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Pabianicka 62 str, 93-513 Lodz, Poland.
Ann Hematol. 2004 Apr;83(4):225-31. doi: 10.1007/s00277-003-0808-9. Epub 2003 Nov 26.
This is a retrospective, multicenter study to evaluate biological features and outcome of elderly patients diagnosed with acute lymphoblastic leukemia (ALL) during the last 10 years in ten hematological centers in Poland. Eighty-seven patients aged 60 years or older were studied. To our knowledge, this is one of the largest group of elderly patients with ALL evaluated. We have not observed differences in immunological subtypes and Ph chromosome incidence as compared with younger adult ALL presented in the literature. Induction chemotherapy was administered in 75 patients. We observed complete remission (CR) in 34 (45%, 95% CI: 33-56%) patients. Induction death occurred in 11 (15%) patients. Thirty patients (40%) showed primary resistance to chemotherapy. Median overall survival (OS) of all patients was 150 days. Median disease-free survival (DFS) of responding patients was 180 days. We observed four long-term survivors (DFS longer than 3 years) in our group of patients. Factors influencing OS were CR achievement, female gender, and WBC below 30 x 10(9)/l. Male gender was the only prognostic factor negatively affecting probability to achieve CR. We have not observed any differences in either biology or outcome between patients aged 60-69 years and those aged more than 70 years. ALL of the elderly is a rare disease with poor prognosis. Further clinical trials evaluating the disease features, outcome, and new therapeutic approaches are warranted.
这是一项回顾性多中心研究，旨在评估波兰十个血液学中心在过去10年中诊断为急性淋巴细胞白血病（ALL）的老年患者的生物学特征和预后。研究了87例60岁及以上的患者。据我们所知，这是评估的最大老年ALL患者群体之一。与文献中报道的年轻成人ALL相比，我们未观察到免疫亚型和Ph染色体发生率的差异。75例患者接受了诱导化疗。我们观察到34例（45%，95%CI：33-56%）患者达到完全缓解（CR）。11例（15%）患者在诱导期死亡。30例（40%）患者对化疗表现出原发性耐药。所有患者的中位总生存期（OS）为150天。缓解患者的中位无病生存期（DFS）为180天。我们在患者组中观察到4例长期存活者（DFS超过3年）。影响OS的因素包括达到CR、女性性别以及白细胞低于30×10⁹/L。男性性别是唯一对达到CR概率有负面影响的预后因素。我们未观察到60-69岁患者与70岁以上患者在生物学或预后方面存在任何差异。老年ALL是一种罕见疾病，预后较差。有必要进一步开展临床试验以评估该疾病的特征、预后及新的治疗方法。
