Clinical Application Of Ascorbic Acid In Senile Acute Myeloid Leukemia

Obiective: Acute myeloid leukemia(AML)is a type of malignant hematopoietic stem cell clone disease.The median age of onset is 65 years old,and the incidence of the disease with the growth of age has a gradually increasing trend.At present,with the continuous improvement and optimization of chemotherapy regimen and the continuous promotion of hematopoietic stem cell transplantation,the treatment effect of the disease is gradually improved,the mortality rate is lower than before and the survival time is prolonged.However,the effect of treatment in elderly patients with acute myeloid leukemia over the age of 60 is still not satisfactory.Therefore,it is still important to find an appropriate treatment plan for this group.Recent studies have reported the inhibitory effect of Ascorbic acid(ASC)on a variety of tumors,but its effect on AML has not been reported.Therefore,this study mainly analyzed the effects of intravenous ascorbic acid induction in chemotherapy on the remission rate and survival of elderly patients with acute myeloid leukemia(AML).Methods:108 newly diagnosed elderly patients with Acute myeloid leukemia(AML)admitted to the first affiliated hospital of anhui medical university from March 2010 to May 2018 were included,all of whom were diagnosed clearly and treated initially,except acute promyelocytic leukemia(APL).According to whether ascorbic acid(ASC)was used intravenously during induction chemotherapy,the patients were divided into the application group(intravenous ascorbic acid was used for,3g/d,?5 days)and the control group.The relationship between complete response rate CR,total survival(OS),disease-free survival(DFS)and early death in the two groups was compared,and the relationship between total ascorbic acid use in the course of chemotherapy and survival of elderly AML was also analyzed,and the influencing factors of early death,overall survival in elderly AML patients were analyzed.Results: The first CR rate in the application group was 52.8%(28/53)and the 1-year OS rate was 56.6% higher than the control group's 32.7%(18/55)and 34.5%,while the early mortality rate was 15.1% lower than the control group's 38.2%,P <0.05.The median OS of the application group was longer than that in the control group(13.3 months 95%CI(9.43~17.17)vs 6.4 month 95% CI(2.04~10.76)).In the elderly AML patients with complete remission,the median DFS was longer in the application group than that in the control group(22.0 months 95%CI(9.08~34.92)vs 18.0 month 95%CI(0.00~55.30)).At the time of diagnosis,patients aged <70 years,lactate dehydrogenase <500IU / L,and white blood cell count <50 × 109 / L were protective factors for early death in elderly patients with AML,while hemoglobin <100g / L was a risk factor for early death.Total ascorbic acid use was associated with overall survival of AML in older adults.Conclusion: Intravenous application of ascorbic acid in the first induction of chemotherapy in elderly AML(non-apl)patients can improve the CR rate,1-year OS rate,reduce early mortality,and prolong the median OS and median DFS of the patients.The total amount of ascorbic acid used in elderly AML patients was a protective factor for overall survival.