老年急性髓系白血病诱导缓解化疗的疗效及预后分析

Remission induction chemotherapy and prognosis analysis of elderly patients with acute myeloid leukemia

目的探讨老年急性髓系白血病（AML）诱导缓解化疗的疗效及预后。方法选择78例年龄65～88岁的AML患者，分为化疗组54例，姑息治疗组24例，收集两组临床资料并随访比较两组的预后。结果化疗组患者共有27例完全缓解（CR），7例部分缓解（PR），总有效率62．96％，而姑息治疗患者未有一例CR；化疗组早期病死率显著低于姑息治疗组，平均总生存时间、1年生存率显著高于姑息治疗组（P均〈0．05），但2年生存率两组间比较无显著差异（P〉0．05），两组生存曲线比较具有统计学差异（Log—rank）（x^2=4．589，P=0．031）；COX回归模型发现是否接受化疗与CCI评分〉2分是影响预后的独立因素。结论老年AML患者仍应选择化疗为主要治疗方案，以提升中位生存期和短期生存率。

Objective To investigate the effectiveness and prognosis of remission induction chemotherapy m elderly patmnts with acute myeloid leukemia （AML）. Methods Seventy - eight cases of AML aged 65 - 88 years in our hospital were collected and divided into chemother- apy group （ n = 54 ） and palliative care group （ n = 24 ）. The clinical data was collected. Follow - up was taken and prognosis was compared be- tween the two groups. Results A total of 27 cases got complete remission （CR）, 7 cases got partial remission （PR） in chemotherapy group; the total effective rate was 62.96%. Patients with palliative treatment had not one case of CR. Early mortality rate was significantly lower in chemo- therapy group than palliative treatment group （ P 〈 0.05 ）. Average overall survival time and 1 - year survival rate in chemotherapy group were significantly higher than the palliative treatment group （ P 〈 0.05 ） , but no significant difference （ P 〉 0.05 ） in the 2 - year survival rate. Two sets of survival curves showed a significant difference （Log -rank X2 = 4. 589, P = 0. 031 ） between two groups; Cox regression model found that whether or not to receive chemotherapy and CCI score 〉 2 points were independent prognostic affecting factors. Conclusion The elderly AML pa- tients should choose chemotherapy as primary treatment program, which improved median survival and short - term survival rates.