Wang Chen-Yu, Huang Huai-Hsuan, Chen Ho-Min, Hsiao Fei-Yuan, Ko Bor-Sheng
School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.
Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Clin Lymphoma Myeloma Leuk. 2021 Aug;21(8):e649-e657. doi: 10.1016/j.clml.2021.03.010. Epub 2021 Mar 29.
Acute myeloid leukemia (AML) is a hematological malignancy originating from myeloid precursor cells, with different cytogenetic abnormalities, genetic mutations and diverse clinical prognoses. We investigated the clinical characteristics, treatment patterns, and outcomes of adult AML patients in Taiwan.
We retrospectively included 3851 patients with AML in the Taiwan Cancer Registry Database from 2011 to 2015. We excluded patients younger than 20 years, with acute promyelocytic leukemia, and with no pathological confirmation.
Among the 3292 patients included, 2179 received induction chemotherapy and 1113 did not, because of older age and higher Charlson comorbidity index (CCI) score. Among the 2179 treated patients, 162 received high-dose cytarabine-based chemotherapy, 1535 received standard-dose cytarabine with anthracyclines, 209 received low-dose cytarabine-based chemotherapy, and 273 received chemotherapy without cytarabine. Patients in the low-dose cytarabine group had the oldest age and highest CCI scores compared with the other groups. In the analysis of overall survival (OS), the median OS of the overall study population was 6.27 months. Treated patients with AML had a longer OS than untreated ones (12.43 months treated vs. 2.03 months not treated; P < .0001). In the multivariate analyses of the treated patients with AML, several factors indicated better prognosis, including receiving standard-dose or high-dose cytarabine, female sex, younger age, lower CCI score, treatment at a medical center, favorable cytogenetic abnormalities, and allogeneic hematopoietic stem cell transplantation.
Our study was a population-based study that illustrates the real-world outcomes of adult patients with AML in Taiwan.
急性髓系白血病（AML）是一种起源于髓系前体细胞的血液系统恶性肿瘤，具有不同的细胞遗传学异常、基因突变和多样的临床预后。我们调查了台湾成年AML患者的临床特征、治疗模式和结局。
我们回顾性纳入了2011年至2015年台湾癌症登记数据库中的3851例AML患者。我们排除了年龄小于20岁、患有急性早幼粒细胞白血病以及未进行病理确诊的患者。
在纳入的3292例患者中，2179例接受了诱导化疗，1113例未接受，原因是年龄较大和查尔森合并症指数（CCI）评分较高。在2179例接受治疗的患者中，162例接受了以大剂量阿糖胞苷为基础的化疗，1535例接受了标准剂量阿糖胞苷联合蒽环类药物的化疗，209例接受了以小剂量阿糖胞苷为基础的化疗，273例接受了不含阿糖胞苷的化疗。与其他组相比，小剂量阿糖胞苷组患者年龄最大，CCI评分最高。在总生存（OS）分析中，整个研究人群的中位OS为6.27个月。接受治疗的AML患者的OS比未接受治疗的患者更长（接受治疗者为12.43个月，未接受治疗者为2.03个月；P <.0001）。在接受治疗的AML患者的多因素分析中，几个因素表明预后较好，包括接受标准剂量或大剂量阿糖胞苷、女性、年龄较小、CCI评分较低、在医疗中心接受治疗、有利的细胞遗传学异常以及异基因造血干细胞移植。
我们的研究是一项基于人群的研究，阐明了台湾成年AML患者的真实世界结局。
