Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2010
[Distribution of WHO subtypes, initial treatment outcomes and prognosis study of 623 unselected adult patients with acute myeloid leukaemia in Shanghai.].
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Sino-US Shanghai Leukemia Cooperative Group
Аннотация
OBJECTIVE: To investigate the current status of acute myeloid leukemia (AML) treatment in Shanghai.
METHODS: From 2003 to 2007, a total of successive 623 patients with adult AML were diagnosed and classified according to WHO criteria. Survival rate or median survival was analysed by Kaplan-Meier curve and COX regression model and to compare the differences in treatment effectiveness with those reported in developed countries and in Shanghai from 1984 to 1994.
RESULTS: Total CR rate was 66.5%, median survival time was 18 months and estimated survival at 3 year was 30.8%. The 3-year relapse rate was 55.1%. The CR rate was similar to that in developed countries, but long-term survival was worse. The CR rate and survival were increased markedly compared with data collected from 1984 to 1994 in Shanghai. Induction regimens based on idarubicin, daunorubicin or homoharringtonine had similar CR rates and survivals. Karyotype was the most important prognostic factor. The CR rate was 87.3% (68/79), 61.8% (189/306) and 42.9% (48/112) in favorable (excluding APL), intermediate and adverse cytogenetic risk groups, respectively. The CR rate of APL was 91.3%. Multilineage dysplasia in de novo AML was not an independent prognostic factor after adjusted by cytogenetics, age and WBC count. Poor karyotype, old age and high WBC count were the most important prognostic factors.
CONCLUSIONS: The CR rate and survival of AML were improved in the past 20 years. The short-term treatment outcome of AML was comparable to that in developed countries, while the long-term one was worse. Improvement in the long-term treatment outcome in China is an important challenge.
METHODS: From 2003 to 2007, a total of successive 623 patients with adult AML were diagnosed and classified according to WHO criteria. Survival rate or median survival was analysed by Kaplan-Meier curve and COX regression model and to compare the differences in treatment effectiveness with those reported in developed countries and in Shanghai from 1984 to 1994.
RESULTS: Total CR rate was 66.5%, median survival time was 18 months and estimated survival at 3 year was 30.8%. The 3-year relapse rate was 55.1%. The CR rate was similar to that in developed countries, but long-term survival was worse. The CR rate and survival were increased markedly compared with data collected from 1984 to 1994 in Shanghai. Induction regimens based on idarubicin, daunorubicin or homoharringtonine had similar CR rates and survivals. Karyotype was the most important prognostic factor. The CR rate was 87.3% (68/79), 61.8% (189/306) and 42.9% (48/112) in favorable (excluding APL), intermediate and adverse cytogenetic risk groups, respectively. The CR rate of APL was 91.3%. Multilineage dysplasia in de novo AML was not an independent prognostic factor after adjusted by cytogenetics, age and WBC count. Poor karyotype, old age and high WBC count were the most important prognostic factors.
CONCLUSIONS: The CR rate and survival of AML were improved in the past 20 years. The short-term treatment outcome of AML was comparable to that in developed countries, while the long-term one was worse. Improvement in the long-term treatment outcome in China is an important challenge.