Analysis Of Clinical Efficacy And Prognostic Factors Of Qinghuang Powder And Low Intensity Chemotherapy In The Treatment Of Elderly Acute Myeloid Leukemia

Objective:Through retrospective analysis,the clinical efficacy and safety of Qinghuang Powder(青黄散,QHP)-based and low-intensity chemotherapy(LIC)in the treatment of elderly patients with acute myeloid leukemia(eAML)were discussed,and the prognostic factors were analyzed.Methods:This study included 106 eAML patients admitted to the Department of Haematology,Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine between January 2015 and June 2022,divided into the QHP group and and LIC group,of which 47 received the QHP-based regimen and 59 received the LIC regimen.The efficacy,survival and adverse effects of the two groups were observed and prognostic factors influencing prognosis were explored.Results:1.Comparative analysis of survival between the two groups of patientsThe survival of 106 patients with eAML was first analysed and the results showed that the median overall survival(mOS)was 10(2～105)months,with a 1year survival rate of 40.95%,a 2-year survival rate of 15.09%and a 3-year survival rate of 8.26%.Further analysis of the survival of the two groups of patients in the QHP group compared to the LIC group showed that the mOS(11 months vs.10 months,X2=0.608,P=0.435),1-year survival(38.30%vs.37.29%,X2=0.011,P=0.915),2-year survival(8.51%vs.16.95%,X2=1.625,P=0.202)and 3-year survival(2.13%vs.11.86%,X2=4.707,P=0.095)were not significantly different(P>0.05).2.Comparative analysis of prognosis between the two groups of patientsA univariate analysis was first performed and the results of the prognosis impact factor analysis of 106 patients with eAML showed that secondary(X2=4.770,P=0.029),physical status score(PS score)(X2=7.585,P=0.006)and genetic(X2=4.893,P=0.027)patients had significant difference in mOS(P<0.05).Analysis of factors influencing prognosis in both groups showed that Hematopoietic cell transplantation-specific comorbidity index(HCT-CI score)of ≥4(10 months vs.9 months,X2=0.229,P=0.632),secondary(10 months vs.8 months,X2=0.217,P=0.641),PS score of≥3(10 months vs.8 months,X2=0.275,P=0.600)and genetically poor prognosis type(9 months vs.8 months,X2=0.168,P=0.682)patients had no significant difference in mOS(P>0.05).A multifactorial analysis was secondly performed and the results of the prognosis impact factor analysis of 106 patients with eAML showed that HCT-CI score(HR=1.067,95%CI:0.666-1.741,P=0.764),secondary(HR=1.522,95%CI:0.937-2.472,P=0.089),PS score(HR=1.628,95%CI:0.976-2.714,P=0.062)and genetic(HR=1.407,95%CI:0.867-2.283,P=0.167)patients had no significant difference in mOS(P>0.05).3.Comparative analysis of occurrence of adverse reactions between the two groups of patientsThe analysis of the occurrence of adverse reactions in the patients in the QHP group and the LIC group showed a significant difference in the incidence of myelosuppression(29.79%vs.81.36%,P<0.05)and no significant difference in the incidence of gastrointestinal reactions(36.17%vs.52.54%,P>0.05)between the two groups.Conclusions:Patients with eAML treated with QHP-based regimen have similar survival compared to LIC regimen,and QHP-based regimen have a significantly lower incidence of myelosuppression than LIC regimen in terms of adverse events.QHP-based regimen may provide an alternative option for patients with eAML who are intolerant to LIC regimen.The prognosis of eAML patients is influenced by a number of factors,including secondary factors,genetic factors and PS score.Secondary factors,genetic factors as well as PS score factors are among them.