Chen Yi, Wang Zhengyang, Cai Ruyu, Wu Zhengjun, Zhou Jiayi, Wu Lanlan, Wu Yong, Zheng Jing
Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fuzhou, China.
School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.
Ann Med. 2025 Dec;57(1):2512120. doi: 10.1080/07853890.2025.2512120. Epub 2025 Jun 2.
This investigation aim to analyze the clinical features and therapeutic outcomes of elderly patients with acute myeloid leukemia (AML).
We conducted a retrospective analysis of the clinical and cytogenetic profiles of patients aged 60 years and older diagnosed with AML at the Fujian Medical University Union Hospital from 2016 to 2024.
Our study cohort included 846 patients, with a median age of 67 years. The median duration of response (DOR) was 15.8 months, with 1-year, 3-year, and 5-year DOR rates of 55.3%, 23.4%, and 13.1%, respectively. The median overall survival (OS) was 21.8 months, with corresponding 1-year, 3-year, and 5-year OS rates of 58.7%, 41.2%, and 30.0%. Patients who received the azacitidine and venetoclax treatment protocol exhibited a complete remission (CR) rate of 57.1% and a minimal residual disease (MRD) - negative rate of 34.1%. These rates were comparable to the 59.2% CR rate and 39.4% MRD-negative rate observed in patients treated with intensive chemotherapy, and were superior to those with other low-intensity regimens. Compared to the treatment outcomes achieved at our center prior to 2016, when chemotherapy was the predominant treatment modality, which were characterized by a CR rate of 42.7%, a median OS of 9.2 months, and a mere 5-year OS rate of 13.5%, the remission rate and long-term survival of elderly patients with AML have been remarkable improved.
The integration of hypomethylating agents and venetoclax into the treatment paradigm for elderly patients with AML has significantly enhanced survival rates.
本研究旨在分析老年急性髓系白血病（AML）患者的临床特征及治疗效果。
我们对2016年至2024年在福建医科大学附属协和医院确诊为AML的60岁及以上患者的临床和细胞遗传学资料进行了回顾性分析。
我们的研究队列包括846例患者，中位年龄为67岁。中位缓解持续时间（DOR）为15.8个月，1年、3年和5年DOR率分别为55.3%、23.4%和13.1%。中位总生存期（OS）为21.8个月，相应的1年、3年和5年OS率分别为58.7%、41.2%和30.0%。接受阿扎胞苷和维奈克拉治疗方案的患者完全缓解（CR）率为57.1%，微小残留病（MRD）阴性率为34.1%。这些比率与接受强化化疗的患者中观察到的59.2%的CR率和39.4%的MRD阴性率相当，并且优于其他低强度方案。与2016年以前我们中心以化疗为主的治疗模式所取得的治疗效果相比，当时CR率为42.7%，中位OS为9.2个月，5年OS率仅为13.5%，老年AML患者的缓解率和长期生存率有了显著提高。
将去甲基化药物和维奈克拉纳入老年AML患者的治疗模式显著提高了生存率。
