Chae Young Kwang, Dimou Anastasios, Pierce Sherry, Kantarjian Hagop, Andreeff Michael
Division of Cancer Medicine, The University of Texas M. D. Anderson Medical Center , TX , USA.
Leuk Lymphoma. 2014 Dec;55(12):2822-9. doi: 10.3109/10428194.2014.901513. Epub 2014 Apr 29.
The effect of calcium channel blockers (CCBs), beta blockers and angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) on the prognosis of patients with acute myeloid leukemia (AML) is largely unknown. We collected data on the use of these medications in 1043 patients with AML, excluding promyelocytic leukemia, diagnosed and treated at M. D. Anderson Cancer Center between 2000 and 2012. Treatment with either amlodipine or diltiazem predicted a worse overall survival (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.22-2.06, p < 0.0001). There was no difference in survival depending on whether patients were taking beta blockers, ACE inhibitors or ARBs. The effect of CCBs on survival was independent from the National Comprehensive Cancer Network risk classification, age, performance status, response to treatment, year of diagnosis and CD34 levels, assessed by flow cytometry (HR 1.39, 95% CI 1.05-1.80, p = 0.02). Treatment with either amlodipine or diltiazem predicts worse survival in patients with AML independent of known prognostic factors.
钙通道阻滞剂（CCB）、β受体阻滞剂以及血管紧张素转换酶（ACE）抑制剂或血管紧张素受体阻滞剂（ARB）对急性髓系白血病（AML）患者预后的影响在很大程度上尚不清楚。我们收集了2000年至2012年间在MD安德森癌症中心诊断和治疗的1043例AML患者（不包括早幼粒细胞白血病）使用这些药物的数据。使用氨氯地平或地尔硫䓬治疗预示总体生存率更差（风险比[HR]1.6，95%置信区间[CI]1.22 - 2.06，p < 0.0001）。患者是否服用β受体阻滞剂、ACE抑制剂或ARB，生存率并无差异。CCB对生存的影响独立于美国国立综合癌症网络风险分类、年龄、体能状态、治疗反应、诊断年份以及通过流式细胞术评估的CD34水平（HR 1.39，95% CI 1.05 - 1.80，p = 0.02）。使用氨氯地平或地尔硫䓬治疗预示AML患者生存率更差，且独立于已知的预后因素。
