Čolović Nataša, Denčić-Fekete Marija, Peruničić Maja, Jurišić Vladimir
1Clinic for Hematology, Clinical Center of Serbia, Koste Todorovica 2, Belgrade, Serbia.
2School of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia.
Indian J Hematol Blood Transfus. 2020 Jan;36(1):59-63. doi: 10.1007/s12288-019-01161-2. Epub 2019 Jul 19.
The hypocellular acute leukemia is very rare atypical leukemia with frequency of 5-7% among patients with acute leukemias. It mainly occurs in older patients and usually has a myeloid phenotype. It is still unclear whether the outcome of hypocellular acute myeloid leukemia is less favorable than adult acute myeloid leukemia with normal cellularity. We retrospectively analyzed all hypocellular acute myeloid leukemias which were treated in 16 years period, between January 1998 and December 2014. There were 33 patients, 21 male and 12 female. The median age of the patients was 58.9 years (ranging from 19 to 88 years) and median cellularity of bone marrow was 16%. All patients presented with cytopenias with median white blood cell count 1.9 × 10/l, platelets 47.2 × 10/l and hemoglobin 85.9 g/l. Nineteen patients were treated with standard 3 + 7 protocol (daunoblastin 45 mg/m 1, 3, 5 days, cytosin-arabinozide 100 mg/m/12 h for 7 days), 5 patients with HDAC protocol and, 3 (9%) with low dose cytosin-arabinoside and in 6 (18.1%) patients only supportive therapy was applied. One patient died on 34 day after treatment with HiDAC, 3 patients after treatment with 3 + 7 regimen in full doses on days 23, 35, and 58 days. Complete remission was achieved in 20/33 (60.60%) patients, with median duration of 14 months. Median overall survival (OS) of the entire cohort was 16 months, and for the treated group 21 months (range 5-67 months). Median OS of patients treated with low dose cytosine-arabinoside was 6 months. The advanced age ( = 0.009, KK = - 0.46, Log rank, = 0.031) as well as therapy options (Log rank < 0.0001) shows a significant correlation with OS. We report a cohort of patients with hypocellular acute myeloid leukemia who responded to standard induction chemotherapy as are in standard acute myeloid leukemia.
低细胞性急性白血病是一种非常罕见的非典型白血病，在急性白血病患者中的发生率为5% - 7%。它主要发生于老年患者，通常具有髓系表型。低细胞性急性髓系白血病的预后是否比细胞数量正常的成人急性髓系白血病更差尚不清楚。我们回顾性分析了1998年1月至2014年12月这16年间治疗的所有低细胞性急性髓系白血病患者。共有33例患者，其中男性21例，女性12例。患者的中位年龄为58.9岁（范围为19岁至88岁），骨髓中位细胞含量为16%。所有患者均出现血细胞减少，中位白细胞计数为1.9×10⁹/L，血小板计数为47.2×10⁹/L，血红蛋白为85.9g/L。19例患者接受标准的3 + 7方案治疗（柔红霉素45mg/m²，第1、3、5天，阿糖胞苷100mg/m²/12小时，共7天），5例患者接受HDAC方案治疗，3例（9%）接受小剂量阿糖胞苷治疗，6例（18.1%）患者仅接受支持治疗。1例患者在接受大剂量阿糖胞苷治疗后第34天死亡，3例患者在接受全剂量3 + 7方案治疗后第23、35和58天死亡。20/33（60.60%）例患者达到完全缓解，中位缓解持续时间为14个月。整个队列的中位总生存期（OS）为16个月，治疗组为21个月（范围为5 - 67个月）。接受小剂量阿糖胞苷治疗的患者中位OS为6个月。高龄（P = 0.009，HR = - 0.46，Log rank，P = 0.031）以及治疗方案（Log rank < 0.0001）与OS显著相关。我们报告了一组低细胞性急性髓系白血病患者，他们对标准诱导化疗的反应与标准急性髓系白血病患者相同。
