文章：

Mayo Clinic 对1123例成年急性髓系白血病患者的诊疗经验

Mayo Clinic experience with 1123 adults with acute myeloid leukemia

原文发布日期：2021-03-02

DOI: 10.1038/s41408-021-00435-1

类型: Article

开放获取: 是

英文摘要：

Between 2004 and 2017, a total of 1123 adult patients (median age 65 years; 61% males) with newly diagnosed acute myeloid leukemia (AML), not including acute promyelocytic leukemia, were seen at the Mayo Clinic. Treatment included intensive (n = 766) or lower intensity (n = 144) chemotherapy or supportive care (n = 213), with respective median survivals of 22, 9, and 2 months (p < 0.01). Intensive chemotherapy resulted in complete remission (CR) and CR with incomplete count recovery (CRi) rates of 44 and 33%, respectively, with no difference in survival outcome between the two (p = 0.4). Allogeneic hematopoietic stem cell transplant (AHSCT) was documented in 259 patients and provided the best survival rate (median 55 months; p < 0.01). After a median follow-up of 13 months, 841 (75%) deaths were recorded. Multivariate analysis identified age >60 years (HR 2.2, 1.9–2.6), adverse karyotype (HR 2.9, 1.9–4.9), intermediate-risk karyotype (HR 1.6, 1.02–2.6), post-myeloproliferative neoplasm AML (HR 1.9, 1.5–2.4), and other secondary AML (HR 1.3 (1.1–1.6) as risk factors for shortened survival. These risk factors retained their significance after inclusion of FLT3/NPM1 mutational status in 392 informative cases: FLT3+NPM1− (HR 2.8, 1.4–5.6), FLT3+/NPM+ (HR 2.6 (1.3–5.2), and FLT3−NPM1− (HR 1.8, 1.0–3.0).
 

摘要翻译： 

2004年至2017年间，梅奥诊所共接诊1123例新诊断的急性髓系白血病（AML）成人患者（中位年龄65岁；男性占61%），不包括急性早幼粒细胞白血病。治疗方案包括强化化疗（n=766）、低强度化疗（n=144）或支持治疗（n=213），中位生存期分别为22个月、9个月和2个月（p<0.01）。强化化疗组的完全缓解（CR）率和血细胞计数不完全恢复的完全缓解（CRi）率分别为44%和33%，两组生存结局无差异（p=0.4）。259例患者接受异基因造血干细胞移植（AHSCT），获得最佳生存率（中位生存期55个月；p<0.01）。中位随访13个月后，记录到841例（75%）死亡。多变量分析确定年龄>60岁（HR 2.2，1.9–2.6）、不良核型（HR 2.9，1.9–4.9）、中危核型（HR 1.6，1.02–2.6）、骨髓增生性肿瘤后AML（HR 1.9，1.5–2.4）及其他继发性AML（HR 1.3，1.1–1.6）为缩短生存期的风险因素。在392例具有明确基因信息的病例中纳入FLT3/NPM1突变状态后，这些风险因素仍保持显著性：FLT3⁺NPM1⁻（HR 2.8，1.4–5.6）、FLT3⁺NPM1⁺（HR 2.6，1.3–5.2）及FLT3⁻NPM1⁻（HR 1.8，1.0–3.0）。

原文链接：

Mayo Clinic experience with 1123 adults with acute myeloid leukemia