| Objective:To analyze the prognostic factors in elderly patients with acute non-lymphocytic leukemia, elderly patients in our department from 2008 to 2013 were retrospectively analyzed.Methods:Clinical data of age, sex, comorbidities, pre-treatment blood, CD34 cells before treatment, chromosomes, and the four kinds of AML prognosis gene mutation of 63 cases of elderly patients (≥60 years) with acute non lymphocytic leukemia from January 2010 to November 2013 in Nanjing Affiliated Drum Tower Hospital were collected, and the patients were divided into chemotherapy group (30 people) and supportive care group (33 people) according to whether chemotherapy was used. Treatment outcome of two groups and prognosis factors of gender, age, CCI score, WBC, HGB, PLT, CD34 levels, chromosomal condition, and AML four kinds prognostic gene mutation were analyzed.. Kaplan-Meier analysis was used and tested by Log-rank. Multivariate linear regression analysis uses COX Linear Regression Analysis. P≤0.05 was statistically significant.Result:1. From 2008 to 2013 in our department,3330 patients were treated (6,174 cases, hospitalized 1.85 times per patient),1375 of them are the elderly (>60 years) patients (1983 cases, hospitalized 1.44 times per patient). The proportion of elderly patients increased from 33.1% in 2008 to 45.0% in 2013.2. The number of elderly male patients was slightly more than women’s. Proportion of patients less than 70 was much more than that of patients over the age of 70, up to 63%. The most common hematological diseases of elderly patients were lymphoma, multiple myeloma and acute non-lymphocytic leukemia.3. In chemotherapy group, the complete remission rate (CR) rate was 50.0%, and the total treatment efficiency was 56.7%. There were 14 cases dead, and the mortality rate was 46.7%.2 cases were treatment-related deaths and the mortality rate was 6.7%. The median survival was 14.3 months, and disease progression-free survival was 12.8 months. In supportive treatment group,29 cases were dead, mortality was 87.9%. A median survival of 2.5 months was observed. The median survival in the chemotherapy group was significantly longer than supportive care group (P<0.0001).4. Univariate analysis suggested that age, high WBC count before treament, chromosomal situation and treatment situation were prognostic factors.5.In multivariate analysis, age, high WBC count before treament, high-risk group of chromosomes, and no reciving chemotherapy were independent prognostic factors.Conclusion:1. The proportion of elderly hematological disese patients was increased, the proportion of the elderly population was much higher than the proportion of the total community population. The total incidence of gender in elderly patients showed no significant differences; elderly patients with the age of less than 70 years had a higher proportion. The most common hematological diseases of elderly patients were lymphoma, multiple myeloma and acute non-lymphocytic leukemia.2. For elderly AML patients, chemotherapy was necessary. After standard chemotherapy, elderly patients could obtain higher CR rate and longer survival.3. Univariate analysis suggested that age, high WBC count before treament, chromosomal situation and treatment situation were prognostic factors.4. WBC count ≥100× 109/L before treament, high-risk group of chromosomes, and no reciving chemotherapy were independent prognostic risk factors, age was not an independent risk factor. |
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