文章：

2000-2014年间AML患者的预后得到改善

Improved outcome for AML patients over the years 2000–2014

原文发布日期：2017-11-29

DOI: 10.1038/s41408-017-0011-1

类型: Original Article

开放获取: 是

英文摘要：

Few recent studies from registries have reported an improvement in overall survival of younger patients with acute myeloid leukemia (AML). However, reasons for this improvement are not defined. We analyzed the therapeutic course and outcome of 976 patients treated by intensive chemotherapy between 2000 and 2014. The number of patients receiving allogeneic stem cell transplantation in first or second response significantly increased over time whereas autologous transplantation was progressively abandoned. In the 513 younger patients, there were no differences in first complete response, induction failure, incidence of relapse, or non-relapse mortality over time. The period of time was significantly associated with a better overall survival especially in 2010–2014. The 2010–2014 period effect was still significant in multivariate analysis and was independent of allogeneic stem cell transplantation. In the 463 older patients, there was a significant interaction between the period and leukocytosis in multivariate analysis meaning that the 2010–2014 period had only an impact in patients with white blood cell count >50 giga/L for response and overall survival. Progresses have been made in each phase of the therapeutic course of younger AML patients resulting in survival improvement. In older patients, the outcome of hyperleukocytic patients has significantly improved in 2010–2014.

摘要翻译： 

近期几项登记研究显示，年轻急性髓系白血病（AML）患者的总体生存率有所改善，但其原因尚未明确。我们分析了2000年至2014年间接受强化化疗的976例患者的治疗过程及结局。数据显示，在首次或第二次缓解期接受异体干细胞移植的患者数量随时间显著增加，而自体移植则逐渐被弃用。在513例年轻患者中，首次完全缓解率、诱导治疗失败率、复发率及非死亡率随时间推移均无显著差异。但研究时间段（尤其是2010-2014年）与更好的总生存期显著相关。多变量分析显示，2010-2014期间的治疗优势仍然显著，且独立于异体干细胞移植的影响。在463例老年患者中，多变量分析显示治疗时期与白细胞增多之间存在显著交互作用，这意味着2010-2014期间的治疗仅对白细胞计数>50×10^9/L患者的缓解率和总生存期产生积极影响。年轻AML患者治疗过程的各个环节均取得进展，从而推动了生存率的提升；而老年患者中高白细胞血症患者的结局在2010-2014年间亦得到显著改善。

原文链接：

Improved outcome for AML patients over the years 2000–2014