| Objective:To provide relevant theoretical basis for the treatment and prognosis of elderly AML patients,andfind the influence factors to the prognosis of patients.Methods:80 cases of elderly AML patients which were diagnosed and had complete clinical data were chosen for this ttudy.There were 35 cases of male and 45 cases of female;the age was from 60 to 86 and the mean age was 69.8±6.5.According to the actural treatment of the patients,all the 80 cases of the patients were divided into three groups: standard chemotherapy group 25 cases,expectant treatment group 41 cases and alleviative treatment group 14 cases.The patient's individual situation,the treatment and other factors were analyzed in order to explore the factors affecting the prognosis of patients.Results:1.In all the 80 elderly AML patients,42 patients were in age 60 – 70,and 38 patients were in age >70.According to the FAB typing,the highest rate type was M2(33.8%),followed by M5(26.3%),M4(23.8%),M0(6.3%),M1(3.8%),M6(3.8%)and M7(2.5%).2.In 80 cases,46 cases(57.5%)of patients had complications,and according to the Charlson complications index scoring,70 cases(87.5%)patients had a score <2,and 10 cases(12.5%)patients had a score ? 2.3.The white blood cell(WBC)count of all the 80 elderly AML patients were in(0.4 –277.4)*109/L.The count of 33 cases(41.3%)were ? 20*109/L;the count of 30 cases(37.5%)were in(20 – 50)*109/L;the count of 17 cases(21.3%)were > 50*109/L.The hemoglobin(HGB)count of all the 80 elderly AML patients were in 57 – 142g/L.70 cases(87.5%)had anemia,including 31 cases of male(HGB<120g/L)and 39 cases of female(HGB<110g/L).38 cases(47.5%)had severe anemia(HGB<60g/L).The blood platelet(PLT)count of all the 80 elderly AML patients were in(5 – 215)*109/L.The count of 34cases(42.5%)were ? 20*109/L;the count of 46 cases(57.5%)were >20*109/L.4.46 cases(57.5%)had bone marrow primitive cells >50%,and 34 cases(42.5%)had bone marrow primitive cells ?50%.61 cases(76.3%)had active bone marrow hyperplasia,and 19 cases(23.8%)had inactive bone marrow hyperplasia.5.The median survival time of all the 80 elderly AML patients was 134 d.6 months and 12 months of cumulative survival rates were 64.0% and 18.0%.24 cases(30.0%)received complete response,and the 15 cases had a median survival time 242 d and 6 months and 12 months of cumulative survival rates 60.0% and 26.7%.6.31 cases(38.8%)had genetic disorders.Chromosome karyotype showed that 15 cases(18.8%)had low risk chromosome karyotype;46 cases(57.5%)had standard risk chromosome karyotype;19 cases(23.8%)had high risk chromosome karyotype.7.Of all influence factors,age(< 70),PS score(0-1),primary AML,no complications,bone marrow primitive cell proportion(?50%),chemotherapy(standard chemotherapy),normal chromosome karyotype and normal genes would make patients get higher CR rates(P<0.05).The Kaplan-Meier survival curve analysis showed that age(< 70),PS score(0-1),primary AML,no complications,white blood cell count before treatment(<50*109/L),bone marrow primitive cell proportion(?50%),chemotherapy(standard chemotherapy)normal chromosome karyotype and normal genes would make patients get longer survival time(P<0.05).8.Age,PS score,complications,white blood cell count before treatmet,treatment,chromosome karyotype and gene mutation were the independent factors affecting the prognosis of patients(P<0.05).The complications,treatment,chromosome karyotype and gene mutation had the greatest influence on the prognosis of patients(P<0.001).Conclusions:There was no standard treatment for elderly AML patients.The treatment effect was not satisfactory.The treatment of elderly AML patients was not taken seriously,not only remission was low,but also the survival time was short and quality of life was poor.Active induction of remission chemotherapy for elderly AML patients would improve the remission rate,survival time and quality of time.Age,PS score,complications,white blood cell count before treatmet,treatment,chromosome karyotype and gene mutation were the independent factors affecting the prognosis of patients.The complications,treatment,chromosome karyotype and gene mutation had the greatest influence on the prognosis of patients. |
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