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急性髓系白血病患者强化诱导治疗后结局的性别差异:一项真实世界单中心分析

Sex-Associated Differences in Outcomes in Acute Myeloid Leukemia Patients Following Intense Induction Treatment: A Real-World Single Center Analysis.

作者信息

Darphin Xenia, Blattner Janina, Hoffmann Michèle, Gobat Katrin, Kronig Marie-Noëlle, Pabst Thomas, Özdemir Berna C

机构信息

Department of Hematology, Spital Limmattal, 8952 Schlieren, Switzerland.

Department of Medical Oncology, Inselspital-Bern University Hospital, University of Bern, 3010 Bern, Switzerland.

出版信息

J Clin Med. 2025 Sep 13;14(18):6457. doi: 10.3390/jcm14186457.

Abstract

Acute myeloid leukemia (AML) is a challenging disease due to its aggressive nature and interindividual variability in treatment response. While sex differences in AML incidence and outcomes have been reported, the impact of sex on treatment-related toxicity remains underexplored. We retrospectively analyzed patients who received intensive chemotherapy for de novo or secondary AML at a single academic hospital between 1 January 2017 and 30 November 2021. A total of 65 patients (62% males) were included, with similar risk categories across sexes. : Although adverse event rates were similar, females had significantly higher rates of neutropenic colitis (100% vs. 80%, = 0.019) after the first induction cycle. Hematological recovery after the second cycle was faster in males for neutrophils (21 vs. 28 days, = 0.025) and thrombocytes (27 vs. 37 days, = 0.02). Hospitalization duration was also significantly longer for females (26 days vs. 24 days, = 0.039). The median overall survival did not differ by sex, but was significantly longer for those receiving two cycles vs. one cycle (0.5 years vs. NR) and for those <60 years old (6.1 vs. 1.0 years). These findings suggest sex-related differences in treatment toxicity and hospital stay length. Larger studies are needed to better understand the impact of sex on AML outcomes.

摘要

急性髓系白血病(AML)因其侵袭性本质和个体治疗反应的差异而成为一种具有挑战性的疾病。虽然已有报道称AML的发病率和治疗结果存在性别差异,但性别对治疗相关毒性的影响仍未得到充分研究。我们回顾性分析了2017年1月1日至2021年11月30日期间在一家学术医院接受强化化疗的初发或继发性AML患者。共纳入65例患者(62%为男性),各性别之间的风险类别相似。尽管不良事件发生率相似,但在第一个诱导周期后,女性中性粒细胞减少性结肠炎的发生率显著更高(100%对80%,P = 0.019)。男性在第二个周期后的血液学恢复更快,中性粒细胞恢复时间(21天对28天,P = 0.025)和血小板恢复时间(27天对37天,P = 0.02)。女性的住院时间也显著更长(26天对24天,P = 0.039)。总体生存中位数在性别上无差异,但接受两个周期化疗的患者比接受一个周期化疗的患者显著更长(0.5年对未达到),且年龄<60岁的患者比年龄≥60岁的患者显著更长(6.1年对1.0年)。这些发现提示了治疗毒性和住院时间长短存在性别相关差异。需要开展更大规模的研究以更好地了解性别对AML治疗结果的影响。

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