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Original Article | Open Access

Treatment patterns and a prognostic scoring system for elderly acute myeloid leukemia patients: a retrospective multicenter cohort study in China

Chunli Zhang1,*, Wei Wan2,*, Shuai Zhang1, Jingwen Wang3, Ru Feng1, Jiangtao Li1, Junyue Chai4, Hebing Zhou5, Liru Wang6, Yuping Zhong7, Xiaodong Mo8, Mengzhu Shen8, Hongmei Jing2 ( ), Hui Liu1 ( )
Department of Hematology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Department of Hematology, Peking University Third Hospital, Beijing 100191, China
Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Department of Hematology, Beijing No. 6 Hospital, Beijing 100007, China
Department of Hematology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
Department of Hematology, Fuxing Hospital, Capital Medical University, Beijing 100038, China
Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China

*These authors contributed equally to this manuscript.

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Abstract

Objective

Acute myeloid leukemia (AML) is primarily a malignant disorder affecting the elderly. We aimed to compare the outcomes of different treatment patterns in elderly AML patients and to propose a prognostic scoring system that could predict survival and aid therapeutic decisions.

Methods

Patients aged ≥ 60 years who had been diagnosed with AML at 7 hospitals in China were enrolled (n = 228). Treatment patterns included standard chemotherapy, low intensity therapy, and best supportive care (BSC).

Results

The early mortality rates were 31%, 6.8%, and 6.3% for the BSC, low intensity therapy, and standard chemotherapy groups, respectively. The complete remission rate of the standard chemotherapy group was higher than that of the low intensity therapy group. The median overall survival (OS) was 561 days and 222 days for the standard chemotherapy and low intensity therapy groups, respectively, and were both longer than that of the BSC group (86 days). Based on multivariate analyses, we defined a prognostic scoring system that enabled classification of patients into 3 risk groups, in an attempt to predict the OS of patients receiving chemotherapies and low intensity therapies. Low and intermediate risk patients benefited more from standard chemotherapies than from low intensity therapies. However, the median OS was comparable between standard chemotherapies and low intensity therapies in high risk patients.

Conclusions

Our prognostic scoring system could predict survival and help select appropriate therapies for elderly AML patients. Standard chemotherapy is important for elderly AML patients, particularly for those categorized into low and intermediate risk groups.

Keywords

chemotherapyelderlycomorbidityAcute myeloid leukemiageriatric assessment

Electronic Supplementary Material

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cbm-19-6-871_ESM.pdf (84.4 KB)

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Cancer Biology & Medicine
Volume 19 Issue 6,
June 2022
Pages 871-883
DOI: 10.20892/j.issn.2095-3941.2020.0474
Cite this article:
Zhang C, Wan W, Zhang S, et al. Treatment patterns and a prognostic scoring system for elderly acute myeloid leukemia patients: a retrospective multicenter cohort study in China. Cancer Biology & Medicine, 2022, 19(6): 871-883. https://doi.org/10.20892/j.issn.2095-3941.2020.0474

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Received: 15 August 2020
Accepted: 14 December 2020
Published: 27 August 2021
©2022 Cancer Biology & Medicine.

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