Role of induction and consolidation chemotherapy in elderly acute myeloid leukemia patients

被引：5

作者：

Kim, Soo-Jeong ^{[1
]}

Cheong, June-Won ^{[1
]}

Kim, Dae-Young ^{[2
]}

Lee, Je-Hwan ^{[2
]}

Lee, Kyoo-Hyung ^{[2
]}

Kim, Yeo-Kyeoung ^{[3
]}

Kim, Hyeong-Joon ^{[3
]}

Song, Ik-Chan ^{[4
]}

Jo, Deog-Yeon ^{[4
]}

Lee, Jeong-Ok ^{[5
]}

Bang, Soo-Mee ^{[5
]}

Park, Jinny ^{[6
]}

Lee, Jae Hoon ^{[6
]}

Lee, Won-Sik ^{[7
]}

Joo, Young-Don ^{[7
]}

Maeng, Chi Hoon ^{[8
]}

Yoon, Hwi-Joong ^{[8
]}

Lee, Na-Ri ^{[9
]}

Kwak, Jae-Yong ^{[9
]}

Kim, Kyoung Ha ^{[10
]}

Won, Jong-Ho ^{[10
]}

Han, Bo Ram ^{[11
]}

Zang, Dae Young ^{[11
]}

Moon, Joon Ho ^{[12
]}

Sohn, Sang Kyun ^{[12
]}

Bae, Sung Hwa ^{[13
]}

Ryoo, Hun Mo ^{[13
]}

Kim, Sung-Yong ^{[14
]}

Lee, Mark Hong ^{[14
]}

Min, Yoo Hong ^{[1
]}

机构：

[1] Yonsei Univ, Coll Med, Severance Hosp, Div Hematol,Dept Internal Med, Seoul 120752, South Korea

[2] Univ Ulsan, Coll Med, Dept Internal Med, Asan Med Ctr, Seoul, South Korea

[3] Chonnam Natl Univ, Hwasun Hosp, Dept Hematol Oncol, Hwasun, Jeollanam Do, South Korea

[4] Chungnam Natl Univ Hosp, Dept Internal Med, Taejon, South Korea

[5] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Songnam, South Korea

[6] Gachon Univ, Gil Hosp, Dept Internal Med, Div Hematol & Oncol, Inchon, South Korea

[7] Inje Univ, Coll Med, Dept Hemato Oncol, Pusan, South Korea

[8] Kyung Hee Univ Seoul, Coll Med, Dept Hematol Oncol, Seoul, South Korea

[9] Chonbuk Natl Univ, Sch Med, Dept Internal Med, Jeonju, South Korea

[10] Soonchunhyang Univ, Coll Med, Dept Internal Med, Div Hematol Oncol, Seoul, South Korea

[11] Hallym Univ, Coll Med, Hallym Univ Med Ctr, Div Hematol Oncol, Seoul, South Korea

[12] Kyungpook Natl Univ Hosp, Dept Hematol & Med Oncol, Taegu, South Korea

[13] Catholic Univ Daegu, Sch Med, Deagu Catholic Med Ctr, Dept Hematol Oncol, Deagu, South Korea

[14] Konkuk Univ, Sch Med, Konkuk Univ Med Ctr, Div Hematol Oncol,Dept Internal Med, Seoul, South Korea

来源：

INTERNATIONAL JOURNAL OF HEMATOLOGY | 2014年 / 100卷 / 02期

关键词：

Elderly AML; Induction; Consolidation; ACUTE MYELOGENOUS LEUKEMIA; COLONY-STIMULATING FACTOR; COUNCIL AML11 TRIAL; OLDER PATIENTS; INTENSIVE CHEMOTHERAPY; TREATMENT OUTCOMES; ONCOLOGY-GROUP; SURVIVAL; AGE; CLASSIFICATION;

D O I：

10.1007/s12185-014-1617-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The present study sought to elucidate the role of induction and consolidation therapy in elderly patients. We retrospectively collected data of 477 patients who were aged over 60 years at the time of acute myeloid leukemia (AML) diagnosis. The median overall survival (OS) was 339 days in the induction group (n = 266) and 86 days in the best supportive care group (n = 211) (P < 0.001). In the induction group, the complete remission (CR) rate was 58.3 %, and treatment-related death was 15.4 %. Successful induction was related to good performance [Eastern Cooperative Oncology Group (ECOG < 2)] [hazard ratio (HR) 3.215; P = 0.002]. Mortality correlated with failure to achieve CR (HR 4.059; P < 0.001) and poor performance status (ECOG > 2) (HR 2.731; P = 0.035). In CR patients, poor karyotype and absence of consolidation (HR 2.313; P = 0.003) correlated with mortality. More than one cycle of consolidation was associated with better OS (P < 0.001). Lack of salvage therapy was associated with mortality in patients who did not achieve CR (HR 3.223; P = 0.005). Intensive induction in patients with good performance and > 1 cycle of consolidation after CR may be the best strategy for improving OS in elderly AML patients.

引用

页码：141 / 151

页数：11

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