Long-term outcome and prognostic factors of elderly patients with acute promyelocytic leukemia
Long-term outcome and prognostic factors of elderly patients with acute promyelocytic leukemia
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DOI：
10.1111/j.1349-7006.2012.02390.x
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发表时间：
2012-11-01
期刊：
影响因子：
5.7
通讯作者：
Naoe, Tomoki
中科院分区：
文献类型：
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作者：
Ono, Takaaki;Takeshita, Akihiro;Naoe, Tomoki
针对老年急性早幼粒细胞白血病（APL）的研究相对有限。为了评估老年APL患者的预后影响，我们在日本成人白血病研究组（JALSG）APL 97研究中比较了老年APL患者（60-70岁）与年轻患者（15-59岁）接受全反式维甲酸联合蒽环类药物和阿糖胞苷治疗的长期结局。在283例可评价患者中，46例（16.3%）为老年患者，在巩固治疗期间血小板降低（P = 0.04）、白蛋白降低（P = 0.006）和体力状态3（P = 0.02）更频繁，分化综合征诱导死亡率（P = 0.03）和非复发死亡率（NRM）更高（P = 0.001）。老年患者的总生存率显著低于老年患者（P = 0.005），但无病生存率和累积复发率则无显著差异。老年APL患者在诱导和巩固治疗期间应考虑更好的治疗方法以减少NRM。本研究在http://www.umin.ac.jp/ctrj/上注册，编号为C 000000206。（Cancer Sci 2012; 103：1974-1978）
Studies focused on elderly acute promyelocytic leukemia (APL) are relatively limited. To evaluate prognostic impact in elderly APL, we compared the long-term outcome of elderly APL patients (60-70 years) with younger patients (15-59 years) treated with all-trans retinoic acid combined with anthracycline and cytarabine in the Japan Adult Leukemia Study Group (JALSG) APL97 study. Of 283 evaluable patients, 46 (16.3%) were elderly who had more frequent lower platelet (P = 0.04), lower albumin (P = 0.006) and performance status 3 (P = 0.02), higher induction death rate due to differentiation syndrome (P = 0.03), and non-relapse mortality (NRM) during consolidation therapy (P = 0.001). Overall survival was significantly inferior in elderly patients (P = 0.005), but disease-free survival and cumulative incidence of relapse were not. Better therapeutic approaches should be considered to reduce NRM during induction and consolidation therapy in elderly APL. This study was registered at http://www.umin.ac.jp/ctrj/ under C000000206. (Cancer Sci 2012; 103: 1974-1978)