Alsulami Hind A, Alnashri Maryam M, Bawazir Alanoud F, Alrashid Laila T, Dly Raghdah A, Alharbi Yusr A, Qari Mohamad H
Hematology Department, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2021 Oct 20;13(10):e18915. doi: 10.7759/cureus.18915. eCollection 2021 Oct.
Acute myeloid leukemia (AML) is a heterogeneous disease. Prognosis and survival depend on several factors that determine tumor behavior and response to therapy. AML has a poor prognosis that depends on several factors: patient's age, gender, body mass index (BMI), baseline white blood cells count, and bone marrow blast (BMB) cell count at the time of diagnosis. Therefore, this study aimed to determine the prognostic role of these factors and their impact on outcomes, and how these prognostic factors may affect AML patients before and after induction chemotherapy.
The study design is an observational, retrospective record review. We included records of patients diagnosed with primary and secondary AML who received chemotherapy between 2013 and 2019 at King Abdulaziz University in Jeddah, Saudi Arabia. Data were extracted from medical records, entered into an Excel sheet (Microsoft Corp., Redmond, WA), and analyzed using SPSS Statistics, version 25 (IBM Corp., Armonk, NY).
Forty-two AML patients who were started on chemotherapy were analyzed. The mean age at diagnosis was 35 ± 22.2 years; 52.4% were male. The ability to achieve the first remission varied according to age group; the 21-45 age group had the higher ability and survival rate of 75.0% On the other hand, the mortality incidence was higher (at 70.0%) in both the 11-20 and the 46-70 age groups. A strong negative correlation was observed between age and survival duration after treatment (SDAT) (r = - 0.618, p = 0.004). The death incidence was increased in the BMI ranges that were under and above the normal weight range. SDAT differed significantly between the three groups in favor of the normal-weight patients (p = 0.019). We found that patients with BMB < 5 had the most deaths. There was a significant negative association between BMB and days to achieve the first remission after treatment (p = 0.033). Conclusion: Age, BMI, and BMB are considered effective prognostic factors for AML patients.
急性髓系白血病（AML）是一种异质性疾病。预后和生存率取决于多种决定肿瘤行为及对治疗反应的因素。AML预后较差，这取决于多个因素：患者的年龄、性别、体重指数（BMI）、基线白细胞计数以及诊断时的骨髓原始细胞（BMB）计数。因此，本研究旨在确定这些因素的预后作用及其对结局的影响，以及这些预后因素在诱导化疗前后如何影响AML患者。
本研究设计为一项观察性回顾性记录审查。我们纳入了2013年至2019年期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学接受化疗的原发性和继发性AML患者的记录。数据从病历中提取，录入Excel表格（微软公司，华盛顿州雷德蒙德），并使用SPSS Statistics 25版（IBM公司，纽约州阿蒙克）进行分析。
对42例开始化疗的AML患者进行了分析。诊断时的平均年龄为35±22.2岁；52.4%为男性。首次缓解的能力因年龄组而异；21 - 45岁年龄组具有较高的缓解能力和生存率，为75.0%。另一方面，11 - 20岁和46 - 70岁年龄组的死亡率较高（均为70.0%）。观察到年龄与治疗后生存持续时间（SDAT）之间存在强负相关（r = - 0.618，p = 0.004）。体重过轻和超重BMI范围的死亡发生率增加。三组之间的SDAT差异显著，正常体重患者更具优势（p = 0.019）。我们发现BMB < 5的患者死亡最多。BMB与治疗后达到首次缓解的天数之间存在显著负相关（p = 0.033）。结论：年龄、BMI和BMB被认为是AML患者有效的预后因素。
