We retrospectively investigated the prognostic factors of acute myeloid leukemia（AML） in 152 Chinese patients with de novo AML who were older than 60 years of age and who received treatment at our hospital.Log-rank ...We retrospectively investigated the prognostic factors of acute myeloid leukemia（AML） in 152 Chinese patients with de novo AML who were older than 60 years of age and who received treatment at our hospital.Log-rank test showed that 6 parameters including older age,higher white blood cell（WBC） counts,lactate dehydrogenase（LDH）and bone marrow（BM） blasts at diagnosis,unfavorable risk cytogenetics,and non-mutated CEBPα were significant adverse prognostic factors of overall survival（OS） for elderly AML patients（P = 0.0013,0.0358,0.0132,0.0242,0.0236 and 0.0130,respectively）.Moreover,older age and higher LDH were significant adverse predictors for relapse-free survival（RFS）（P = 0.0447 and 0.0470,respectively）.Univariate analysis revealed similar results for OS to those of the log-rank test and only higher LDH at diagnosis was a significant adverse predictor for RFS（P = 0.028,HR：1.979,95%CI：1.075-3.644）.In multivariate analysis,we identified 2 trends towards independent prognostic factors for OS,including BM blasts at diagnosis（P = 0.057,HR：1.676,95%CI：0.984-2.854）and mutation status of CEBPα（P = 0.064,HR：4.173,95%CI：0.918-18.966）.Our data indicated that older age,gender and a previous history of hematologic diseases resulted in lower complete remission rate（P = 0.012,0.051 and 0.086,respectively）.We further developed an easy scoring system for predicting prognosis and response to induction therapy in older AML patients.Patients who had lower scores showed significantly longer OS and RFS（P = 0.0006 and 0.1001,respectively） and higher CR rate（P = 0.014）.Our research is limited by its retrospective nature and the results from our study need to be further validated by prospective randomized clinical trials.展开更多
Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one pa...Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one patients with AML(aged 55-71 years) were randomly divided into two groups(Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival(RFS). Results · A total of 29 patients(70.7%) achieved complete remission(CR). The estimated 2-year overall survival(OS) was 66.8% in Group HCAG and 75.4% in Group IA(P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA(P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.展开更多
Objective To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447acute myeloid leukemia(AML)patients.Methods EVI1expressions were measured in 447 AML cases from Jan.2007 to Ap...Objective To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447acute myeloid leukemia(AML)patients.Methods EVI1expressions were measured in 447 AML cases from Jan.2007 to Apr.2015 to couple with clinical。展开更多
Objective To analyze efficacy and safety of CLAG regimen in patients with refractory or relapsed acute myeloid leukemia(AML).Methods Efficacy and adverse events of patients with refractory or relapsed AML who were tre...Objective To analyze efficacy and safety of CLAG regimen in patients with refractory or relapsed acute myeloid leukemia(AML).Methods Efficacy and adverse events of patients with refractory or relapsed AML who were treated with one course of CLAG from April 1st,2014 through December 9th,2015 in our hospital were retrospectively reviewed.Results Thirty-three展开更多
Objective:To analyze the overall survival(OS)of elderly acute myeloid leukemia(AML)patients treated with oral arsenic-containing Qinghuang Powder(青黄散,QHP)or low-intensity chemotherapy(LIC).Methods:Forty-two elderly...Objective:To analyze the overall survival(OS)of elderly acute myeloid leukemia(AML)patients treated with oral arsenic-containing Qinghuang Powder(青黄散,QHP)or low-intensity chemotherapy(LIC).Methods:Forty-two elderly AML patients treated with intravenous or subcutaneous LIC(1 month for each course,at least 3 courses)or oral QHP(3 months for each course,at least 2 courses)were retrospectively analyzed from January 2015 to December 2017.The main endpoints of analysis were OS and 1-,2-,3-year OS rates of patients,respectively.And the adverse reactions induding bone marrow suppression,digestive tract discomfort and myocardia injury were observed.Results:Out of 42 elderly AML patients,22 received LIC treatment and 20 received QHP treatment,according to patients'preference.There was no significant difference on OS between LIC and QHP patients(13.0 months vs.13.5 months,P>0.05).There was no significant difference on OS rates between LIC and QHP groups at 1 year(59.1%vs.70.0%),2 years(13.6%vs.15%),and 3 years(4.6%vs.5.0%,all P>0.05).Furthermore,there was no significant difference of OS on prognosis stratification of performance status>2(12 months vs.12 months),age>75 year-old(12.0 months vs.12.5 months),hematopoietic stem cell transplant comorbidity index>2(12 months vs.13 months),poor cytogenetics(12 months vs.8 months),and diagnosis of secondary AML(10 months vs.14 months)between LIC and QHP patients(P>0.05).Conclusion:QHP may be an alternative treatment for elderly AML patients refusing LIC therapy.展开更多
基金supported by National Natural Science Foundation of China(No.81170486,81170485 and 81101498)Natural Science Fund for Distinguished Young Scholars of Jiangsu Province(BK20130049)+4 种基金Scientific Research Foundation from the Ministry of Education of China(43-NJYKDX-3)Jiangsu Province's Medical Elite Program(RC2011168)Key Project of Jiangsu Province Health Agency(K201107)"Liu Da Ren Cai Gao Feng"Project(2012-WS-017)A Project funded by the Priority Academic Program Development of Jiangsu Higher Education Institute(JX10231801)
文摘We retrospectively investigated the prognostic factors of acute myeloid leukemia（AML） in 152 Chinese patients with de novo AML who were older than 60 years of age and who received treatment at our hospital.Log-rank test showed that 6 parameters including older age,higher white blood cell（WBC） counts,lactate dehydrogenase（LDH）and bone marrow（BM） blasts at diagnosis,unfavorable risk cytogenetics,and non-mutated CEBPα were significant adverse prognostic factors of overall survival（OS） for elderly AML patients（P = 0.0013,0.0358,0.0132,0.0242,0.0236 and 0.0130,respectively）.Moreover,older age and higher LDH were significant adverse predictors for relapse-free survival（RFS）（P = 0.0447 and 0.0470,respectively）.Univariate analysis revealed similar results for OS to those of the log-rank test and only higher LDH at diagnosis was a significant adverse predictor for RFS（P = 0.028,HR：1.979,95%CI：1.075-3.644）.In multivariate analysis,we identified 2 trends towards independent prognostic factors for OS,including BM blasts at diagnosis（P = 0.057,HR：1.676,95%CI：0.984-2.854）and mutation status of CEBPα（P = 0.064,HR：4.173,95%CI：0.918-18.966）.Our data indicated that older age,gender and a previous history of hematologic diseases resulted in lower complete remission rate（P = 0.012,0.051 and 0.086,respectively）.We further developed an easy scoring system for predicting prognosis and response to induction therapy in older AML patients.Patients who had lower scores showed significantly longer OS and RFS（P = 0.0006 and 0.1001,respectively） and higher CR rate（P = 0.014）.Our research is limited by its retrospective nature and the results from our study need to be further validated by prospective randomized clinical trials.
基金National Natural Science Foundation of China(81270621,81300451)National Public Health Grand Research Foundation(201202003)+1 种基金Shanghai Health System Advanced and Appropriate Technology Promotion Projects(2013SY001)Multiple Clinical Research Center Program of Shanghai Jiao Tong University School of Medicine(DLY201513)
文摘Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one patients with AML(aged 55-71 years) were randomly divided into two groups(Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival(RFS). Results · A total of 29 patients(70.7%) achieved complete remission(CR). The estimated 2-year overall survival(OS) was 66.8% in Group HCAG and 75.4% in Group IA(P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA(P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.
文摘Objective To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447acute myeloid leukemia(AML)patients.Methods EVI1expressions were measured in 447 AML cases from Jan.2007 to Apr.2015 to couple with clinical。
文摘Objective To analyze efficacy and safety of CLAG regimen in patients with refractory or relapsed acute myeloid leukemia(AML).Methods Efficacy and adverse events of patients with refractory or relapsed AML who were treated with one course of CLAG from April 1st,2014 through December 9th,2015 in our hospital were retrospectively reviewed.Results Thirty-three
基金Supported by Special Grants of Clinical Research Base of Traditional Chinese Medicine,State Administration of Traditional Chinese Medicine(No.JDZX2012180)。
文摘Objective:To analyze the overall survival(OS)of elderly acute myeloid leukemia(AML)patients treated with oral arsenic-containing Qinghuang Powder(青黄散,QHP)or low-intensity chemotherapy(LIC).Methods:Forty-two elderly AML patients treated with intravenous or subcutaneous LIC(1 month for each course,at least 3 courses)or oral QHP(3 months for each course,at least 2 courses)were retrospectively analyzed from January 2015 to December 2017.The main endpoints of analysis were OS and 1-,2-,3-year OS rates of patients,respectively.And the adverse reactions induding bone marrow suppression,digestive tract discomfort and myocardia injury were observed.Results:Out of 42 elderly AML patients,22 received LIC treatment and 20 received QHP treatment,according to patients'preference.There was no significant difference on OS between LIC and QHP patients(13.0 months vs.13.5 months,P>0.05).There was no significant difference on OS rates between LIC and QHP groups at 1 year(59.1%vs.70.0%),2 years(13.6%vs.15%),and 3 years(4.6%vs.5.0%,all P>0.05).Furthermore,there was no significant difference of OS on prognosis stratification of performance status>2(12 months vs.12 months),age>75 year-old(12.0 months vs.12.5 months),hematopoietic stem cell transplant comorbidity index>2(12 months vs.13 months),poor cytogenetics(12 months vs.8 months),and diagnosis of secondary AML(10 months vs.14 months)between LIC and QHP patients(P>0.05).Conclusion:QHP may be an alternative treatment for elderly AML patients refusing LIC therapy.
