Characteristics and results of the treatment of patients with acute myeloid leukaemia ≥ 60 years – data from the CELL DATOOL AML database
Authors:
Z. Šustková 1; L. Semerád 1; J. Procházková 1; P. Cetkovský 2; P. Žák 3; J. Novák 4; T. Szotkowski 5; Z. Kořístek 6; L. Burešová 7; J. Mayer 1; Z. Ráčil 1
Authors‘ workplace:
Interní hematologická a onkologická klinika FN Brno
1; Ústav hematologie a krevní transfuze
2; IV. interní hematologická klinika FN Hradec Králové
3; Interní hematologická klinika FN Královské Vinohrady
4; Hemato-onkologická klinika FN Olomouc
5; Klinika hematoonkologie FN Ostrava
6; DSC Services, s. r. o., Tišnov
7
Published in:
Transfuze Hematol. dnes,25, 2019, No. 4, p. 340-348.
Category:
Original Papers
Overview
Background: The DATOOL AML database was founded on Jan 1, 2017. Its purpose is to collect data of patients with AML from diagnosis and throughout treatment and follow up. The objective of this study is to describe the epidemiologic, clinical and laboratory data and the analyse overall survival in relation to negative risk factors and selected therapy. The analysis was performed on a group of patients over 60 years of age diagnosed with AML who were added to the database in the period from Jan 1, 2007 to Dec 31, 2017.
Patients and Methods: A total of 1008 patients with AML ≥ 60 years of age were analysed. The group was further divided into two age subgroups (60–69 years, ≥ 70 years) in order to determine possible differences in the incidence of negative prognostic factors, the therapeutic approach chosen and overall survival.
Results: The median of age at diagnosis was 68 years. The most common negative prognostic factors were poor performance status (ECOG 2–4) in 42 %, secondary AML in 32 % and unfavourable cytogenetics in 30 % of patients. Only performance status showed correlation with patient age. 33% of patients received curative, 34 % palliative and 32 % symptomatic treatment. Only 18 % patients undergoing curative therapy received allogeneic stem cell transplantation in first CR. The median overall survival for the entire group was 3.5 months. In the age group 60–69 years the median was 4.5 months and in the age group above 70 the median was 2.4 months (p < 0.0001). The negative factors impacting the overall survival were identified as ECOG 2–4, non-curative therapeutic approach and poor cytogenetic risk. There was a negative correlation between the median overall survival and ECOG (4.7 months for ECOG 0–1; 2.4 months for ECOG 2 and 0.8 months for ECOG 3–4, p < 0.0001). The median overall survival also decreased with higher cytogenetic risk (12.2; 5.8 and 2.9 months for favourable, intermediate and poor risk respectively, p < 0.0001). Compared to palliative therapy, curative therapy significantly prolonged overall survival in both age subgroups (median 8.9 and 3.7 months respectively, p < 0.0001 in the age group 60–69 years; 7.7 and 3.9 months, p = 0.029 in the age group ≥ 70 years). Patients from the age group 60–69 with poor cytogenetic risk receiving curative therapy who underwent allogeneic stem cell transplantation showed a higher survival rate (median OS 10.4 months). Patients who did not receive allogeneic stem cell transplantation showed a similar survival rate as patients with high cytogenetic risk in the age group 60–69 receiving palliative treatment (3.3 and 3.6 months respectively, p = 0.884).
Keywords:
acute myeloid leukaemia – elderly patients – DATOOL database
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