80岁以上老年急性髓系白血病24例临床分析

Clinical Analysis of 24 Acute myeloid Leukemia Patients Aged over 80 Years

目的:探讨80岁以上老年急性髓系白血病(AML)的临床特点。方法:回顾性分析24例80岁以上AML(非M3型)患者的临床资料,分析患者的临床特点,以及仅接受支持治疗和接受减低剂量化疗和或地西他滨治疗患者的疗效和生存时间。结果:24例患者FAB分型M2型10例(41. 7%),M4型7例(29. 2%),M5型4例(16. 7%),未分型3例(12. 5%)。22例(91. 0%)患者合并基础疾病。13例接受减低剂量化疗和或地西他滨治疗的患者中8例(61. 5%)获得PR及以上的缓解。接受化疗患者的中位生存时间为30周,显著高于支持治疗患者(中位生存时间9周)(P <0. 05)。单因素分析显示,WBC≥50×109/L、ECOG评分≥2和接受支持治疗为生存期的预后不良因素。结论:80岁以上急性髓系白血病患者接受个体化治疗的患者半数以上获得PR及以上的疗效,且较支持治疗有更长的生存期。

Objective: To investigate the clinical features of acute myeloid leukemia patients aged over 80 years.Methods: The clinical data from 24 cases of acute myeloid leukemia( non-M3) aged over 80 years w ere analyzed retrospectively. Clinical characteristics,therapeutic efficacy and overall survival rate of the patients received low dose chemotherapy and/or decitabine w ere compared w ith that received only supportive care. Results: According to FAB classification,the 10 patients w ere M2 subtypes( 41. 7%),the 7 patients w ere M4 subtypes( 29. 2%),the 4 patiens w ere M5( 16. 7%),the 3 patients w ere unclassifed( 16. 5%). 22 patients( 91. 0%) w ere complicated w ith underling diseases. Among 13 patients received low dose chemotherapy or decitabine,8 cases( 61. 5%) achived partial remission or higher remission. The median survival time of patients w ho reseived chemotherapy w as 30 w eeks,and signicantly longer than that of patients received supportive care( median survival time w as 9 w eeks( P < 0. 05)). The univariated analysis show ed that WBC≥50 × 10^9/L,ECOG ≥2 and received supportive care w ere unfavonrable prognostic factors for overall survival. Conclusion: M ore than half of patients aged over 80 years w ho received individudized treatment can achieve partial remission or higher remission,and can have more longer survival time.