Jiang Jinhong, Liu Yonghua, Zeng Yuxiao, Lan Yifen, Fang Bingmu
Department of Hematology, The Sixth Hospital Affiliated to Wenzhou Medical University, Wenzhou, 323000, China.
Ann Hematol. 2025 Sep 18. doi: 10.1007/s00277-025-06455-2.
The survival and death cause in elderly acute promyelocytic leukemia (APL) patients were analyzed and a prognosis model was constructed. Retrospectively, the medical data of elderly APL patients (N = 1723, from year 2000 to 2020) were gained from surveillance, epidemiology, and end results (SEER) database, and patients were randomly divided into train set and test set 1 (7:3). Test set 2 was composed of 17 APL patients from our hospital. Single factor and multi-factor analyses were performed by COX regression analysis. Death causes were analyzed among dead APL patients. Prognosis prediction model was constructed and verified. Single factor analysis results showed that age, marital status, income, year of diagnosis, months from diagnosis to treatment and chemotherapy were highly correlated with the death of APL patients. Multi-factor analysis results indicated that age, year of diagnosis and chemotherapy could independently serve as predictors to the death of APL patients. More patient succumbed to APL relative to other causes. The prognosis model had a higher diagnostic value for 0.5-year (AUC = 0.797) overall survival in train set, and for 2-year (AUC = 0.784) overall survival in test set 1. 1-year survival prediction in train set and test set 1 indicated the stability of the model. Age, year of diagnosis and chemotherapy are the independent risk factors, and APL is the leading cause of death in elderly APL patients. The prognosis model has a good clinical prediction value for elderly APL patients.
分析老年急性早幼粒细胞白血病（APL）患者的生存及死亡原因，并构建预后模型。回顾性收集2000年至2020年老年APL患者（N = 1723例）的医疗数据，数据来源于监测、流行病学和最终结果（SEER）数据库，患者被随机分为训练集和测试集1（7:3）。测试集2由我院的17例APL患者组成。采用COX回归分析进行单因素和多因素分析。对死亡的APL患者分析其死亡原因。构建并验证预后预测模型。单因素分析结果显示，年龄、婚姻状况、收入、诊断年份、从诊断到治疗的月数以及化疗与APL患者的死亡高度相关。多因素分析结果表明，年龄、诊断年份和化疗可独立作为APL患者死亡的预测因素。相对于其他原因，更多患者死于APL。该预后模型对训练集0.5年总生存（AUC = 0.797）及测试集1的2年总生存（AUC = 0.784）具有较高的诊断价值。训练集和测试集1的1年生存预测表明模型具有稳定性。年龄、诊断年份和化疗是独立危险因素，APL是老年APL患者的主要死亡原因。该预后模型对老年APL患者具有良好的临床预测价值。
