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虚弱指数在预测接受强化化疗的老年和年轻急性髓系白血病患者完全缓解、入住重症监护病房及总体死亡率方面的表现。

Performance of the frailty index in predicting complete remission, intensive care unit admission, and overall mortality in older and younger patients with acute myeloid leukemia receiving intensive chemotherapy.

作者信息

Petrov Dmitriy, Timilshina Narhari, Papadopoulos Efthymios, Alibhai Shabbir M H

机构信息

Department of Medicine, University Health Network, Toronto, Canada.

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

出版信息

Leuk Lymphoma. 2022 Sep;63(9):2189-2196. doi: 10.1080/10428194.2022.2064993. Epub 2022 Apr 22.

Abstract

The frailty index (FI) predicts clinical outcomes in oncology. However, in the acute myeloid leukemia (AML) setting, its predictive ability is poorly understood. We assessed whether the FI predicts complete remission (CR), intensive care unit (ICU) admission, and 1-year all-cause mortality in younger and older adults with AML receiving intensity chemotherapy. This was a secondary analysis of a prospective study. In total, 237 patients ( = 140 younger and  = 97 older adults) were classified as non-frail, prefrail, or frail. Frail younger adults were less likely to achieve CR compared with non-frail younger adults. Pre-frail and frail younger adults were more likely to be admitted to the ICU compared with their non-frail counterparts. The FI was not predictive of 1-year all-cause mortality. The FI predicts CR and ICU admission in younger but not older adults. Disease biology may be more important than frailty in predicting 1-year overall mortality in patients with AML undergoing chemotherapy.

摘要

衰弱指数(FI)可预测肿瘤学中的临床结局。然而,在急性髓系白血病(AML)患者中,其预测能力尚不清楚。我们评估了FI是否能预测接受强化化疗的年轻和老年AML患者的完全缓解(CR)、重症监护病房(ICU)入院情况以及1年全因死亡率。这是一项前瞻性研究的二次分析。总共237例患者(n = 140例年轻患者和n = 97例老年患者)被分类为非衰弱、衰弱前期或衰弱。与非衰弱的年轻成人相比,衰弱的年轻成人实现CR的可能性较小。与非衰弱的年轻成人相比,衰弱前期和衰弱的年轻成人更有可能入住ICU。FI不能预测1年全因死亡率。FI可预测年轻成人的CR和ICU入院情况,但不能预测老年成人的情况。在预测接受化疗的AML患者1年总死亡率方面,疾病生物学可能比衰弱更重要。

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