Prognostic factors for therapy-related acute myeloid leukaemia (t-AML) - A single centre experience

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• 作者：Nada Suvajd啪i膰^a ; ^b ; Zorica Cvetkovi膰^c ; ^{zokabora@yahoo.com} ; Vesna 膼or膽evi膰^b ; Nada Kraguljac-Kurtovi膰^b ; Dejana Stanisavljevi膰^a ; Andrija Bogdanovi膰^a ; ^b ; Irena 膼juni膰^b ; Nata&scaron ; a 膶olovi膰^a ; ^b ; Ana Vidovi膰^a ; ^b ; Ivo Elezovi膰^a ; ^b ; Dragica Tomin^a ; ^b
• 关键词：Therapy-related acute myeloid leukaemia ; Prognostic factors ; Performance status ; Comorbidity ; Cytogenetics
• 刊名：Biomedicine and Pharmacotherapy
• 出版年：2012
• 期刊代码：36_07533322
• 类别：med
• 出版时间：June, 2012
• 卷：66
• 期：4
• 页码：285-292
• 文件大小：554 K

摘要

Prognostic parameters for treatment outcome in 42 consecutive patients with t-AML diagnosed and treated in a single centre between 2000-2010 (mean age: 56.07 years, range: 23-84; 30 females) were evaluated retrospectively/prospectively. Antecedent malignancy occurred in 37 patients (88.15%): 28 solid cancers (breast, n = 14), nine haematological. History of previous chemotherapy (CT), radiotherapy (RT) alone and combined CT/RT was present in 42.9%, 6.19%and 30.1%patients, respectively. Primary disease was active in 11 patients (six relapsed or metastatic cancers; five autoimmune diseases). Myelodysplastic syndrome preceded t-AML in 29%of patients. Median latency period from prior CT/RT was 54.62 months (range: 6-243). Median WBC count was 27.23 脳 10⁹/L, platelet count 62.29 脳 10⁹/L, haemoglobin level 87.83 g/L, peripheral blood and bone marrow blast percentage 30.7%and 66.7%respectively, serum LDH 1216 U/L. Aberrant expression of B or T lymphoid markers was registered in seven out of 39 and six out of 39 patients, respectively. Aberrant karyotype was detected in 24 out of 33 (72.7%) of eligible patients: favourable: 15.2%, intermediate: 42.4%and unfavourable: 42.4%. Eastern Cooperative Oncology Group (ECOG) performance status greater or equal to 2 and Haematopoietic Cell Transplantation Specific Comorbidity Index (HCT-CI) greater or equal to 3 exhibited 83.3%and 76.2%patients, respectively. Intensive induction CT for t-AML was administered in 24 patients. The median follow-up and the median overall survival (OS) for the whole cohort were 2 months and 5.94 months (range: 0.5-34), respectively. In 10 patients (23.8%) achieving complete remission (CR), median disease free survival (DFS) was 11.8 months (range: 4-32). Only CD19 expression, pretreatment karyotype, ECOG PS, HCT-CI and activity of primary disease had impact on OS (P < 0.05).