title: Easily manageable prognostic factors in 152 Chinese elderly acute myeloid leukemia patients: a single-center retrospective study.
abstract: We retrospectively investigated the prognostic factors of acute myeloid leukemia (AML) in 152 Chinese patients with de novo AML who were older than 60 years of age and who received treatment at our hospital. Log-rank test showed that 6 parameters including older age, higher white blood cell (WBC) counts, lactate dehydrogenase (LDH) and bone marrow (BM) blasts at diagnosis, unfavorable risk cytogenetics, and non-mutated CEBPα were significant adverse prognostic factors of overall survival (OS) for elderly AML patients (P  =  0.0013, 0.0358, 0.0132, 0.0242, 0.0236 and 0.0130, respectively). Moreover, older age and higher LDH were significant adverse predictors for relapse-free survival (RFS) (P  =  0.0447 and 0.0470, respectively). Univariate analysis revealed similar results for OS to those of the log-rank test and only higher LDH at diagnosis was a significant adverse predictor for RFS (P  =  0.028, HR: 1.979, 95%CI: 1.075-3.644). In multivariate analysis, we identified 2 trends towards independent prognostic factors for OS, including BM blasts at diagnosis (P  =  0.057, HR: 1.676, 95%CI: 0.984-2.854) and mutation status of CEBPα (P  =  0.064, HR: 4.173, 95%CI: 0.918-18.966). Our data indicated that older age, gender and a previous history of hematologic diseases resulted in lower complete remission rate (P  =  0.012, 0.051 and 0.086, respectively). We further developed an easy scoring system for predicting prognosis and response to induction therapy in older AML patients. Patients who had lower scores showed significantly longer OS and RFS (P  =  0.0006 and 0.1001, respectively) and higher CR rate (P  =  0.014). Our research is limited by its retrospective nature and the results from our study need to be further validated by prospective randomized clinical trials.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Jiadai
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Tingmei
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Huayuan
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: WenYi
authors.initials: W
authors.lastname: Shen
authors.affiliation: Department of Clinical Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Sixuan
authors.initials: S
authors.lastname: Qian
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Jianyong
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
keywords: acute myeloid leukemia; elderly patients; prognosis factors