Miyamoto Toshihiro, Sanford David, Tomuleasa Ciprian, Hsiao Hui-Hua, Olivera Leonardo José Enciso, Enjeti Anoop Kumar, Gimenez Conca Alberto, Castillo Teresa Bernal Del, Girshova Larisa, Martelli Maria Paola, Guvenc Birol, Delgado Alexander, Duan Yinghui, Garbayo Guijarro Belen, Llamas Cynthia, Lee Je-Hwan
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Leukemia/Bone Marrow Transplant Program of BC, Division of Hematology, The University of British Columbia, Vancouver, BC, Canada.
Leuk Lymphoma. 2022 Apr;63(4):928-938. doi: 10.1080/10428194.2021.2002321. Epub 2022 Feb 11.
Acute myeloid leukemia (AML) predominantly affects the elderly, and prognosis declines with age. Induction chemotherapy plus consolidation therapy is standard of care for fit patients; options for unfit patients include hypomethylating agents (HMA), low-dose cytarabine (LDAC), targeted therapies, and best supportive care (BSC). This retrospective chart review evaluated clinical outcomes in unfit patients with AML who initiated first-line treatment or BSC 01/01/2015-12/31/2018. Overall survival (OS), progression-free survival (PFS), time-to-treatment failure (TTF), and response rates were assessed. Of 1762 patients, 1310 received systemic therapies: 809 HMA, 199 LDAC, and 302 other therapies; 452 received BSC. Median OS was 9.9, 7.9, 5.4, and 2.5 months for HMA, LDAC, other, and BSC, respectively. Median PFS was 7.5, 5.3, 4.1, and 2.1 months for HMA, LDAC, other, and BSC, respectively; median TTF was 4.9, 2.1, 2.2, and 2.1 months, respectively. Our findings highlight the unmet need for novel therapies for unfit patients.
急性髓系白血病（AML）主要影响老年人，且预后随年龄增长而下降。诱导化疗加巩固化疗是适合患者的标准治疗方案；不适合的患者的治疗选择包括去甲基化药物（HMA）、小剂量阿糖胞苷（LDAC）、靶向治疗和最佳支持治疗（BSC）。这项回顾性图表审查评估了2015年1月1日至2018年12月31日开始一线治疗或BSC的不适合AML患者的临床结局。评估了总生存期（OS）、无进展生存期（PFS）、治疗失败时间（TTF）和缓解率。在1762例患者中，1310例接受了全身治疗：809例接受HMA，199例接受LDAC，302例接受其他治疗；452例接受BSC。HMA、LDAC、其他治疗和BSC的中位OS分别为9.9个月、7.9个月、5.4个月和2.5个月。HMA、LDAC、其他治疗和BSC的中位PFS分别为7.5个月、5.3个月、4.1个月和2.1个月；中位TTF分别为4.9个月、2.1个月、2.2个月和2.1个月。我们的研究结果凸显了不适合患者对新型治疗方法的未满足需求。
