首页|50岁以上AML患者总体生存及预后影响因素分析

50岁以上AML患者总体生存及预后影响因素分析

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目的:探讨50岁以上急性髓系白血病患者生存情况和预后影响因素.方法:回顾性分析本院2016年1月至2021年6月收治的50岁以上急性髓系白血病患者共222例的临床资料,采用Kaplan-Meier方法评估总体生存率,Cox回归模型评估预后影响因素.结果:全部患者1、3年总体生存率分别为46.8%、28.8%,随访时间段内获得缓解的患者复发率为57%.单因素及多因素分析结果均显示,年龄大、MLL家族融合基因、PHF6基因突变、TP53基因突变、不耐受标准的治疗方案、未获得完全缓解、复杂染色体核型、+mar染色体核型、inv(3)染色体核型与不良预后显著相关(均P<0.05).融合基因阴性、AML-ETO融合基因阳性在本研究人群中无明显生存优势.在获得完全缓解的患者中,是否获得MRD阴性的患者总体生存率无显著差异.结论:50岁以上急性髓系白血病患者总体预后差,复发率高,预后受多因素影响且有该人群自身特点.
Analysis of Factors Influencing Overall Survival and Prognosis of AML Patients Over 50 Years Old
Objective:To explore the overall survival and prognostic factors of patients over 50 years old with acute myeloid leukemia(AML).Methods:The clinical data of 222 AML patients aged over 50 years in our hospital from January 2016 and June 2021 were retrospectively analyzed.Kaplan-Meier method was used to evaluate the overall survival(OS)rate,and Cox regression model to evaluate the prognostic factors.Results:The 1-year and 3-year OS rates of all patients were 46.8%and 28.8%,respectively.The recurrence rate of patients who achieved remission during follow-up time was 57%.Both univariate and multivariate analysis showed that advanced age,MLL family fusion gene,PHF6 gene mutation,TP53 gene mutation,intolerance to standard chemotherapy,incomplete remission,complex karyotype,+mar karyotype and inv(3)karyotype were significantly correlated with prognosis(all P<0.05).Negative fusion gene and positive AML-ETO fusion gene had no obvious survival advantage in this population.In patients with complete remission,there was no significant survival advantage in those who achieved minimal residual disease negative.Conclusion:AML patients aged over 50 years have a poor outcome and high recurrence rate.The prognosis is affected by multiple factors and has its own characteristics.

acute myeloid leukemiaoverall survivalprognostic factorsgene mutation

刘红、李智、史玉叶、陶善东、王春玲、于亮

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南京医科大学附属淮安第一医院血液科,南京医科大学血液病重点实验室

南京医科大学附属淮安第一医院甲乳科,江苏淮安 223300

急性髓系白血病 总体生存 预后影响因素 基因突变

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(4)
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