Lokesh Kadabur Nagendrappa, Pehalajani Jitendra Kumar, Loknatha Dassappa, Jacob Linu Abraham, Babu M C Suresh, Rudresha A H, Rajeev Lakkavalli Krishnappa, Smitha S C, Ashok Khandare Pravin, Madhumathi D S
Department of Medical Oncology, Kidwai Cancer Institute, Marigowda Road, Bangalore, 560029 India.
Department of Pathology, Kidwai Cancer Institute, Marigowda Road, Bangalore, 560029 India.
Indian J Hematol Blood Transfus. 2020 Jan;36(1):47-50. doi: 10.1007/s12288-019-01143-4. Epub 2019 Jun 6.
The median age of diagnosis for chronic myeloid leukemia (CML) in India is 35 years on the contrary to western literature which is 47 years. The outcome of the elderly patient in CML TKI era is not reported from the Indian population. However, Western literature suggests that use of TKI alleviate the adverse impact of age in outcomes of CML. This study was carried out to analyze the clinical profile and outcome of elderly, in comparison with younger patients with CML. We retrospectively analyzed CML patients treated at our department from January 2008 to December 2017. The data cutoff date was December 2018. The cohorts of 712 patients were divided into two groups. Patients belonging to the age group of ≥ 60 years were classified as the study group and those who were 18-60 years were used as controls. Patient's clinical history, examination and milestones in terms of achieving hematological, molecular responses and toxicity profile were also recorded. The total of 712 patients, 52 patients in the study group and 660 patients in the control group were treated during the study period. The study group was having more co-morbidities than the control group (15.3% vs. 4.5%). Patients having high-risk EUTOS score were similar in both groups (38.4% vs. 37.6%). The patients presented in blast phase were higher in the study group as compared to control group (9.6% vs. 6.36%) but the differences were not statistically significant. Rates of achieving a hematological response at 3 months (85.1% vs. 86.89%) and the major molecular response at 18 months (54.3% vs. 60.16%) were almost similar in both groups. However, hematological toxicity, muscle cramps and gastritis were reported more in elderly patients. The outcome of CML patients in TKI era do not differ in elderly patients. However, toxicity profile was not significantly inferior in elderly patients.
在印度，慢性髓性白血病（CML）的诊断中位年龄为35岁，这与西方文献报道的47岁相反。印度人群中尚未报道CML酪氨酸激酶抑制剂（TKI）时代老年患者的治疗结果。然而，西方文献表明，使用TKI可减轻年龄对CML治疗结果的不利影响。本研究旨在分析老年CML患者与年轻患者相比的临床特征和治疗结果。我们回顾性分析了2008年1月至2017年12月在我科接受治疗的CML患者。数据截止日期为2018年12月。712例患者被分为两组。年龄≥60岁的患者被归类为研究组，18 - 60岁的患者作为对照组。还记录了患者的临床病史、检查情况以及在实现血液学、分子反应和毒性特征方面的关键指标。在研究期间，共治疗了712例患者，其中研究组52例，对照组660例。研究组的合并症比对照组更多（15.3%对4.5%）。两组中具有高危欧洲白血病网络（EUTOS）评分的患者相似（38.4%对37.6%）。研究组处于急变期的患者比对照组更高（9.6%对6.36%），但差异无统计学意义。两组在3个月时达到血液学反应的率（85.1%对86.89%）和18个月时达到主要分子反应的率（54.3%对60.16%）几乎相似。然而，老年患者中血液学毒性、肌肉痉挛和胃炎的报告更多。TKI时代CML老年患者的治疗结果与年轻患者并无差异。然而，老年患者的毒性特征并非明显较差。
