Treatment challenges and outcomes of older patients with acute myeloid leukemia from India

被引：1

作者：

Singh, Suvir ^{[1
]}

Lionel, Sharon ^{[2
]}

Jain, Hasmukh ^{[3
]}

Rajendra, Akhil ^{[4
]}

Nayak, Lingaraj ^{[3
]}

Selvarajan, Sushil ^{[2
]}

Samuel, Prasanna ^{[5
]}

Ahmed, Rayaz ^{[6
]}

Aggarwal, Narendra ^{[6
]}

Ds, Pavitra ^{[7
]}

Byreddy, Poojitha ^{[7
]}

John, Mjoseph ^{[7
]}

Mishra, Kundan ^{[8
]}

Kumar, Suman ^{[8
]}

Paul, Mobin ^{[9
]}

Abraham, Latha K. ^{[9
]}

Kayal, Smita ^{[10
]}

Ganesan, Prasanth ^{[10
]}

Philip, Chepsy C. ^{[11
]}

Das, Damodar ^{[12
]}

Sreeraj, V ^{[13
]}

Mehta, Prashant ^{[14
]}

Pk, Jayachandran ^{[4
]}

Raghavan, Vineetha ^{[15
]}

Bala, Stalin Chowdary ^{[16
]}

Bharath, Ram S. ^{[17
]}

Majumdar, Swaratika ^{[18
]}

Prakash, Om ^{[5
]}

Barath, U. ^{[5
]}

Bagal, Bhausaheb ^{[3
]}

Abraham, Aby ^{[2
]}

Kapoor, Rajan ^{[8
]}

Bhurani, Dinesh ^{[6
]}

Sengar, Manju ^{[3
]}

Mathews, Vikram ^{[2
]}

机构：

[1] Dayanand Med Coll, Dept Clin Haematol, Ludhiana 141001, India

[2] Christian Med Coll & Hosp, Vellore, India

[3] Tata Mem Hosp, Mumbai, India

[4] Canc Inst Adyar, Chennai, India

[5] CMC, Dept Biostat, Vellore, India

[6] Rajiv Gandhi Canc Inst & Res Ctr, New Delhi, India

[7] Christian Med Coll & Hosp, Ludhiana, India

[8] Army Hosp Res & Referral, New Delhi, India

[9] Rajagiri Hosp, Kochi, India

[10] Jawaharlal Inst Postgrad Med Educ & Res, Pondicherry, India

[11] Believers Church Med Coll Hosp, Thiruvalla, India

[12] Guwahati Med Coll, Gauhati, India

[13] Amala Canc Hosp & Res Ctr, Trichur, India

[14] Asian Inst Med Sci AIMS, Faridabad, India

[15] Malabar Canc Ctr, Thalassery, Kerala, India

[16] Nizams Inst Med Sci NIMS, Hyderabad, India

[17] Narayana Hlth Hosp, Bengaluru, India

[18] Ramaiah Med Coll & Hosp RMCH, Bengaluru, India

来源：

ANNALS OF HEMATOLOGY | 2024年 / 103卷 / 10期

关键词：

AML; Leukemia; Cancer; Fungal; Chemotherapy; REAL-WORLD DATA; INTENSIVE CHEMOTHERAPY; SURVIVAL; AZACITIDINE; THERAPY; ADULTS; AML; AGE;

D O I：

10.1007/s00277-024-05873-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Globally, overall survival (OS) of older patients with AML continues to be suboptimal with very little data from India. In a multicenter registry analysis, we evaluated 712 patients with AML older than 55 years. Only 323 (45.3%) underwent further treatment, of which 239 (74%) received HMAs, and 60 (18%) received intensive chemotherapy (IC). CR was documented in 39% of those receiving IC and 42% after HMAs. Overall, 100 (31%) patients died within 60 days of diagnosis, most commonly due to progressive disease (47%) or infections (30%). After a median follow-up of 176 days, 228 (76%) of patients had discontinued treatment. At one year from diagnosis, 211 (65%) patients had died, and the median OS was 186 days (IQR, 137-234). Only 12 (3.7%) patients underwent stem cell transplantation. Survival was significantly lower for those older than 60 years (p < 0.001). Patients who died had a higher median age (p = .027) and baseline WBC counts (p = .006). Our data highlights suboptimal outcomes in older AML patients, which are evident from 55 years of age onwards, making it necessary to evaluate HMA and targeted agent combinations along with novel consolidation strategies to improve survival in this high-risk population.

引用

页码：4079 / 4088

页数：10

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