Clinical Characteristics And Survival Factors Of 74 Elderly Patients With Acute Myeloid Leukemia

Objective To summarize and analyze the clinical features,treatment outcome and survival factors of elderly patients with acute myelogenous leukemia.Methods A total of 74 patients with newly diagnosed acute myeloid leukemia(AML)were enrolled in the General Hospital of Ningxia Medical University from January 1,2010 to June 30,2016,Among them,including 42 males and 32 females.Median age 65.Results 1.A total of 40 patients received chemotherapy.Among them,25 cases received standard chemotherapy,Median overall survival time was 5.5 months.the CR rate was 32%,and the median recurrence free survival time was 332.5 days.Chemotherapy related mortality 16%.The 9 patients received priming regimen,The median overall survival time was 5 months.and the rate of CR was about 44.5%,the median recurrence free survival time was 157.5 days(day 22~756).and the chemotherapy related mortality rate was 11.1%.No significant difference.There was no significant difference in CR rate and median survival time between the two groups.2.The total CR rate was 42.5%in the chemotherapy group.The median survival time was 8.5 months.There was no CR in the non chemotherapy group,the median survival time was 1.5 months.There were significant differences.3.56 cases of patients with chromosome karyotype analysis,which accounted for 17.9%of high-risk group,the middle risk group accounted for 76.8%,low-risk group accounted for 5.4%.A total of 37patients received chemotherapy,the results of the high risk group,the total CR rate of 16.7%;the middle risk group of the total CR rate of 44.8%,no significant difference.4.Single factor analysis showed that the number of white blood cells,LDH value,the proportion of bone marrow progenitor cells,and whether or not receiving chemotherapy were the main factors affecting the prognosis.The results of multivariate analysis:WBC?50×10~9/L,no chemotherapy were independent risk factors for survival.5.Patients receiving chemotherapy showed IV bone marrow suppression.The infection rate was 85%.The incidence of gastrointestinal reaction was 42.5%,and the incidence of hemorrhage was about 27.5%.A total of 6 patients died,5 died of infection,and 1 died of cerebral hemorrhage.Conclusion Conclusion 1.The possible factors affecting the patient's therapeutic effect and survival included the high complications of elderly patients with acute myeloid leukemia,the high level of Secondary leukemia and the low proportion of receiving standard chemotherapy.2.There were no Significant difference between different chemotherapy regimens in complete remission rate,treatment-related death and survival time.3.No chemotherapy and high white blood cell count(WBC?50×10~9/L)were independent risk factors for unfavourable prognosis.The possible factors included the proportion of bone marrow progenitor cells and the high-risk chromosome karyotype.4.Bone marrow suppression and infection are the most common adverse reaction to chemotherapy.Infection and hemorrhage is the main cause of treatment-related death.