Mendoza-Urbano Diana Marcela, Tello-Cajiao Maria Elena, Rosales Joaquin, Ahumada Fabian Emiliano, Parra-Lara Luis Gabriel, Arrieta Elizabeth
Centro de Investigaciones Clinicas (CIC), Fundacion Valle del Lili, Cali, Colombia.
Servicio de Hemato-Oncologia, Departamento de Medicina Interna, Fundacion Valle del Lili, Cali, Colombia.
J Hematol. 2023 Feb;12(1):7-15. doi: 10.14740/jh1055. Epub 2022 Dec 1.
Acute myeloid leukemia (AML) is a hematological neoplasm that is more frequent in elderly patients. The objective of this study was to evaluate elderly patients' survival with AML and acute myeloid leukemia myelodysplasia-related (AML-MR), treated with intensive and less-intensive chemotherapy and supportive care.
A retrospective cohort study was conducted in Fundacion Valle del Lili (Cali, Colombia), between 2013 and 2019. We included patients ≥ 60 years old diagnosed with AML. The statistical analysis considered the leukemia type ( vs. myelodysplasia-related) and treatment (intensive chemotherapy regimen, less-intensive chemotherapy regimen, and without chemotherapy). Survival analysis was performed using Kaplan-Meier method and Cox regression models.
A total of 53 patients were included (31 and 22 AML-MR). Intensive chemotherapy regimens were more frequent in patients with leukemia (54.8%), and 77.3% of patients with AML-MR received less-intensive regimens. Survival was higher in the chemotherapy group (P = 0.006), but with no difference between chemotherapy modalities. Additionally, patients without chemotherapy were 10 times more likely to die than those who received any regimen, independent of age, sex, Eastern Cooperative Oncology performance status, and Charlson comorbidity index (adjusted hazard ratio (HR) = 11.6, 95% confidence interval (CI) 3.47 - 38.8).
Elderly patients with AML had longer survival time when receiving chemotherapy, regardless of the type of regimen.
急性髓系白血病（AML）是一种血液系统肿瘤，在老年患者中更为常见。本研究的目的是评估接受强化和非强化化疗及支持治疗的老年AML患者和急性髓系白血病骨髓增生异常相关（AML-MR）患者的生存情况。
2013年至2019年在Fundacion Valle del Lili（哥伦比亚卡利）进行了一项回顾性队列研究。我们纳入了年龄≥60岁、诊断为AML的患者。统计分析考虑了白血病类型（与骨髓增生异常相关）和治疗方式（强化化疗方案、非强化化疗方案和未化疗）。使用Kaplan-Meier方法和Cox回归模型进行生存分析。
共纳入53例患者（31例AML和22例AML-MR）。AML患者接受强化化疗方案的频率更高（54.8%），77.3%的AML-MR患者接受非强化方案。化疗组的生存率更高（P = 0.006），但化疗方式之间无差异。此外，未接受化疗的患者死亡可能性是接受任何化疗方案患者的10倍，与年龄、性别、东部肿瘤协作组体能状态和Charlson合并症指数无关（调整后风险比（HR）= 11.6，95%置信区间（CI）3.47 - 38.8）。
老年AML患者接受化疗时生存时间更长，无论化疗方案类型如何。
