Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Gwangju, Korea.
PLoS One. 2021 May 7;16(5):e0251011. doi: 10.1371/journal.pone.0251011. eCollection 2021.
The clinical characteristics and therapeutic strategy in acute myeloid leukemia (AML) are influenced by patients' age. We evaluated the impact of age on remission induction therapy for AML.
We retrospectively analyzed 3,011 adult AML patients identified from a nationwide database between January 2007 and December 2011.
Three hundred twenty-nine (10.9%) acute promyelocytic leukemia (APL) and 2,682 (89.1%) non-APL patients were analyzed. The median age was 51 years and 55% of patients were male. Six hundred twenty-three patients (21%) were at favorable risk, 1522 (51%) were at intermediate risk, and 743 (25%) were at poor risk. As the age increased, the proportion of those at favorable risk and who received induction chemotherapy decreased. After induction therapy, complete response (CR) was achieved in 81.5% (243/298) of APL and 62.4% (1,409/2,258) of non-APL patients; these rates decreased as the age increased, with an obvious decrement in those older than 60 years. The median overall survival of non-APL patients was 18.7 months, while that of APL patients was not reached, with a 75% five-year survival rate.
Age impacts both the biology and clinical outcomes of AML patients. Further studies should confirm the role of induction remission chemotherapy by age group.
急性髓系白血病（AML）的临床特征和治疗策略受患者年龄的影响。我们评估了年龄对 AML 缓解诱导治疗的影响。
我们回顾性分析了 2007 年 1 月至 2011 年 12 月期间全国数据库中确定的 3011 例成人 AML 患者。
329 例（10.9%）为急性早幼粒细胞白血病（APL），2682 例（89.1%）为非 APL。中位年龄为 51 岁，55%为男性。623 例（21%）为低危，1522 例（51%）为中危，743 例（25%）为高危。随着年龄的增长，低危患者和接受诱导化疗的患者比例下降。诱导治疗后，298 例 APL 患者中有 81.5%（243/298）和 2258 例非 APL 患者中有 62.4%（1,409/2,258）获得完全缓解（CR）；随着年龄的增长，这些比率下降，60 岁以上患者的比率明显下降。非 APL 患者的中位总生存期为 18.7 个月，而 APL 患者未达到，五年生存率为 75%。
年龄影响 AML 患者的生物学和临床结局。进一步的研究应该证实按年龄组进行诱导缓解化疗的作用。
