Efficacy of different remission induction chemotherapy and prognostic analysis in elderly patients with acute myeloid leukemia

Bao Li; Jiang Hao; Jiang Qian; Zhu Honghu; Wang Jing; Wen Lei; Jiang Bin

doi:10.3760/cma.j.issn.1673-4777.2014.01.020

Abstract：Objective To explore the biological characteristics and effect of induction chemotherapy(IC) and prognostic analysis in elderly patients with acute myeloid leukemia (AML).Methods The clinical data of 75 AML patients older than 60 years in the institute of hematology,Peking university from February 2008 to February 2013 were analyzed retrospectively.70 patients received chemotherapy,including 18 patients receiving standard protocol such as DA,IA or HAA.43 patients received small dose protocol such as CAG,CHG or MA.The median survival time was compared between the three groups.The prognostic factors were evaluated by univariate and multivariate analysis.Results Thirty-three cases (47.1％) achieved complete remission (CR) ; 11 cases (15.7％) achieved partial remission (PR) ; 26 cases(37.1％) did not relieve and 8 patients died after the first course of chemotherapy.3 patients stopped chemotherapy and received only supportive treatment due to poor condition.Fifty-nine patients continued the second course; the CR,PR,NR and death were 72.9％ (42 cases),5.1％ (3 cases),23.7％ (14 cases) and 5.1％ (3 cases),respectively.The second period of treatment response rate was 60.0％ (42/70) ; the overall CR after 2 courses of chemotherapy was 67.1％ (47/70).The refractory AML occupied 14 patients(20.0％).Multi-factor analysis showed that aged ＞ 65 years [odds ratio (OR)=2.36,95％ confidence interval (CI) 1.09-5.10],bad prognosis of chromosomes (OR =2.24,95％ CI 1.01-4.94)and the standard induction chemotherapy (OR =2.48,95％ CI 1.25-4.92) were the main factors affecting survival.Conclusion Elderly patients with favorable or intermediate risk cytogenetics should be encouraged to receive standard chemotherapy.