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2010-2020 年芬兰急性髓细胞白血病患者的治疗和临床结局:电子健康记录的回顾性分析。

Treatment and clinical outcomes of patients with acute myeloid leukemia in Finland 2010-2020: A retrospective analysis of electronic health records.

机构信息

Turku University Hospital, Turku, Finland.

AbbVie, Inc., Helsinki, Finland.

出版信息

Eur J Haematol. 2024 Nov;113(5):664-674. doi: 10.1111/ejh.14272. Epub 2024 Jul 29.

Abstract

Our retrospective study (2010-2020) examined treatment patterns, outcomes, and healthcare resource utilization in Finnish acute myeloid leukemia (AML) patients. Data covered 153 patients diagnosed at Hospital District of Southwest Finland (HDSF) and 107 from other districts who underwent allogeneic stem cell transplantation (aSCT) at HDSF. Of the 153 patients, 56.2% received intensive chemotherapy (IC), while 43.8% deemed ineligible for IC received low-intensity therapies or best supportive care (BSC). Median overall survival for IC patients was 31.2 months, compared to 5.3 months for those under azacytidine and 1.2 months on BSC. Majority (57.5%) of patients over 60 with intermediate/high European leukemia network risk had poor outcomes with IC and couldn't proceed to aSCT. These patients carried the highest costs and hospital resource use per patient month. Most common reasons for transplant ineligibility after IC were refractory disease and infection. Our data provides a comprehensive view on AML treatment landscape from a period when the latest treatment advancements were not yet accessible. The data describes patient groups with poor prognosis and increased healthcare burden, emphasizing the need to improve treatment practices and identify better ways to get more patients to transplant, in a rapidly evolving treatment landscape.

摘要

我们的回顾性研究(2010-2020 年)调查了芬兰急性髓系白血病(AML)患者的治疗模式、结果和医疗资源利用情况。数据涵盖了在西南芬兰大区医院(HDSF)诊断的 153 名患者和在 HDSF 接受异基因干细胞移植(aSCT)的其他地区的 107 名患者。在 153 名患者中,56.2%接受了强化化疗(IC),而 43.8%因不适合 IC 而接受低强度治疗或最佳支持治疗(BSC)。IC 患者的中位总生存期为 31.2 个月,而接受阿扎胞苷治疗的患者为 5.3 个月,接受 BSC 治疗的患者为 1.2 个月。57.5%的年龄在 60 岁以上、具有中/高危欧洲白血病网络风险的患者接受 IC 治疗效果不佳,无法进行 aSCT。这些患者的治疗费用和每个患者每月的医院资源使用量最高。IC 后移植不合格的最常见原因是疾病难治和感染。我们的数据提供了一个关于 AML 治疗现状的全面视图,涵盖了最新治疗进展尚未普及的时期。这些数据描述了预后较差和医疗负担增加的患者群体,强调需要改进治疗实践,并寻找更好的方法让更多的患者接受移植,因为治疗领域正在迅速发展。

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