Analysis of Early Death in Elderly Patients with Acute Promyelocytic Leukemia Treated with Arsenic Trioxide Induction
Objective To analyze the occurrence and predictive factors of early death(ED)in elderly(≥60 years old)patients with newly diagnosed acute promyelocytic leukemia(APL)induced by single-agent arsenic trioxide(ATO).Methods The clinical da-ta of 71 consecutive elderly APL patients and 456 consecutive young APL patients were collected.Ten clinical and laboratory parameters,which could be obtained rapidly by clinicians were selected.Chi-square test and Logistic regression analysis were used for statistical a-nalysis.Results The ED rate in elderly patients(22.5%,16/71)was higher than that in young patients(15.1%,69/456),but the difference was not statistically significant(P=0.115).The incidence of infection-related ED(8.5%)and thrombosis-related ED(2.3%)in elderly patients was significantly higher than that in young patients(2.0%and 0.3%,respectively),and the difference was statistically significant(P<0.01).Peripheral white blood cell count>10 × 109/L and male were independent risk factors for ED in both the elderly and young patients.And hypoalbuminemia(P<0.001)and plasma fibrinogen<1g/L(P=0.001)were still independent risk factors for ED only in young patients.Conclusion When induced by single-agent ATO,the elderly APL patients were significantly different from the young patients in terms of clinical features,incidence and risk factors of ED.Therefore age-stratified study on ED in APL is necessary.