Dou X L, Zhao T, Xu L P, Zhang X H, Wang Y, Chen H, Chen Y Y, Yan C H, Han W, Wang F R, Wang J Z, Chen Y, Jiang H, Zhu H H, Jia J S, Wang J, Jiang B, Wang D B, Liu K Y, Huang X J, Jiang Q
Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 Dec 14;39(12):969-976. doi: 10.3760/cma.j.issn.0253-2727.2018.12.001.
To explore age-related clinical characteristics, early responses and outcomes in non-senile adults with de novo acute myeloid leukemia (AML). Data of consecutive cases of 18-65 years adults with de novo AML (non-acute promyelocytic leukemia) were reviewed retrospectively. Clinical characteristics at diagnosis, early responses and outcomes across different age groups of patients were analyzed. 1 097 patients were enrolled. 591 (53.9%) were male. Median age was 42 years. Increasing age was significantly associated with decreasing WBC count (=0.003), increasing PLT count (=0.034), lower blast proportions in bone marrow (=0.021). The incidence of NPM1(+)/FLT3-ITD(-) increased with age (<0.001). Multivariate analyses showed that increasing age was associated with low probabilities of achieving morphologic leukemia free state (MLFS) (=0.053) and complete remission (CR) (=0.004) and poor overall survival (OS) (=0.070) in the whole patients population. However, increasing age was not associated with low MLFS rate and poor OS, except low CR rate (=0.075) in those receiving standard induction regimen instead of low-intensity regimen. There were significant differences on clinical characteristics, cytogenetics and molecular genetics across different age groups in non-senile adults with de novo AML. In the patients receiving standard induction regimen, age was not associated with MLFS rate and OS.
探讨初发急性髓系白血病（AML）非老年成人患者与年龄相关的临床特征、早期反应及预后。回顾性分析18至65岁初发AML（非急性早幼粒细胞白血病）连续病例的数据。分析不同年龄组患者的诊断时临床特征、早期反应及预后。共纳入1097例患者。其中男性591例（53.9%）。中位年龄为42岁。年龄增加与白细胞计数降低（=0.003）、血小板计数增加（=0.034）、骨髓原始细胞比例降低（=0.021）显著相关。NPM1(+)/FLT3-ITD(-)的发生率随年龄增加而升高（<0.001）。多因素分析显示，在全体患者中，年龄增加与达到形态学无白血病状态（MLFS）的概率降低（=0.053）、完全缓解（CR）的概率降低（=0.004）及总生存期（OS）较差（=0.070）相关。然而，除接受标准诱导方案而非低强度方案的患者CR率较低（=0.075）外，年龄增加与MLFS率低及OS差无关。初发AML非老年成人患者不同年龄组在临床特征、细胞遗传学和分子遗传学方面存在显著差异。在接受标准诱导方案的患者中，年龄与MLFS率及OS无关。
