Pretreatment risk factors and importance of comorbidity for overall survival, complete remission, and early death in patients with acute myeloid leukemia.
The objective of this single-center study was to determine the pretreatment risk factors and influence of comorbidity on outcome in patients with acute myeloid leukemia (AML). The research involved 145 patients with AML during a 58-month follow-up period. The results suggest that the most significant predictor of poor overall survival (OS) is an adverse karyotype (P = 0.007), while for poor rate of complete remission (CR) it is age ≥55 years, and for early death the most significant predictor is comorbidity, as scored by the Hematopoetic Cell Transplantation Comorbidity Index (HCT-CI), P = 0.001. When we divided the patients into two groups: aged ≥55 years and aged <55 years, these predictors differed. In the group aged ≥55 years the most significant predictor of OS (P = 0.013) and for early death (P = 0.003) was HCT-CI (P = 0.013), while in the younger group it was karyotype (P < 0.001). The most significant predictor of CR in the elderly was increased serum lactate dehydrogenase (LDH) level (P = 0.045). In the younger patients, the most significant predictor of CR was leukocytosis (P = 0.001) and for early death it was infection as the comorbidity (P = 0.007). We point out the importance of comorbidity for OS and early death, as well as the impact of infection in patients with AML.
Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia. irenadju@eunet.rs
Irena
I
Djunic
Marijana
M
Virijevic
Aleksandra
A
Novkovic
Vladislava
V
Djurasinovic
Natasa
N
Colovic
Ana
A
Vidovic
Nada
N
Suvajdzic-Vukovic
Dragica
D
Tomin
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D059785:Karyotype; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D007964:Leukocytosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D016896:Treatment Outcome
D015415:Biomarkers; D007770:L-Lactate Dehydrogenase