Objective: To investigate the cytogenetic characteristics and prognostic risk factors for elderly patients with newly diagnosed elderly acute myeloid leukemia(AML).
Methods: Cytogenetic test results of 76 elderly patients with AML admitted to the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from April 2015 to December 2021 were retrospectively analyzed, and analyzed clinical characteristics of patients and risk factors influencing prognosis.
Results: According to cytogenetic risk stratification, 76 newly treated elderly AML patients were divided into the favorable, intermediate, and unfavorable groups with 6(7.9%), 58(76.3%), and 12(15.8%) cases, respectively. There was no significant difference in the patient's clinical characteristics and prognosis with the cytogenetics-risk classification groups. Correlation analysis showed that patients' objective response rate (ORR) was related to the age of onset and the mutation status of the CEBPA gene. Logistic regression analysis found that age ≥70 years was an independent risk factor for patients' ORR (OR=0.110, P=0.005). Remission determined the 1-year OS rate (OR=0.049, P=0.005).
Conclusion: There is no significant difference in clinical characteristics among aged AML patients treated at initial treatment in different cytogenetic risk groups. The age of onset ≥70 years is the determinant of whether patients can obtain ORR, and the rate of ORR is closely related to the 1-year OS rate.
题目: 初治老年急性髓系白血病患者细胞遗传学 及临床特征分析.
目的: 探讨初治老年急性髓系白血病（AML）患者细胞遗传学特征及影响预后的风险因素.
方法: 回顾性分析 2015年4月至2021年12月于中国科学技术大学附属第一医院（安徽省立医院）血液科接受治疗的 76例初治老年AML患者的细胞遗传学检验结果，并分析患者的临床特征及影响预后的风险因素.
结果: 76 例初治老年AML患者按细胞遗传学危险分层，分为预后良好、中等、不良3组，分别为6例（7.9%）、58例（76.3%）、12例（15.8%）。不同遗传学危险组间患者临床特征及预后均无明显差异。Pearson’s相关性分析发现患者客观缓解率（ORR）与发病年龄、CEBPA基因突变状态相关；Logistic回归分析结果显示，年龄≥70岁是患者ORR的独立风险因素（OR＝0.110，P=0.005），而治疗能否取得缓解决定其1年OS率（OR＝0.049，P=0.005）.
结论: 与细胞遗传学和其他预后因素相比，发病年龄≥70岁是初治老年AML患者预后的独立风险因素，ORR率决定其1年OS率.
Keywords: acute myeloid leukemia; cytogenetics; elderly; objective response rate.