Efficacy Of Induction Chemotherapy And Prognosis In Elderly Patients With Acute Myeloid Leukemia

Objective To explore the efficacy of remission induction chemotherapy(IC) and prognosis in elderly patients with acute myeloid leukemia (AML).Methods The clinical data of 156 patients of older than 60 years with acute myeloid leukemia in the Institute of Hematology,Union Hospital of Fujian Medical University from January 2003 to July 2010 were analyzed retrospectively.104 patients received cytarabine-based regimens, including protocol DA,IA or CAG,while 52 patients did not receive induction chemotherapy(NIC).The median survival time was compared between patients with and without IC.The prognostic factors were evaluated by using univariate and multivariate analyses.Results 0f all the patients,145 cases were followed-up. Among 96 patients who received IC, 48(50.0%)achieved a complete remission (CR), whereas none of 49 patients who received NIC achieved a CR. The 4-week mortality for patients who received IC and NIC was 4.2% and 40.8%, respectively.The median survival time for patients who received IC was 316 days,compared with 37 days for patients received NIC (P<0.001).Not receiving induction chemotherapy,high-risk karyotype,hyperleukocytosis (≥100×109/L), Charlson Comorbidity Index (CCI)≥2 were adverse prognostic factors of the survival time with univariate analysis, and all were independent poor factors affecting the surviva1 time with multivariate analysis.Conclusion The study suggests that IC could improve outcomes in elderly AML patients.The patients with hyperleukocytosis(≥100×109/L),high- risk karyotype,CCI≥2 and without receiving IC have poorer prognosis.