Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China
Objective To investigate efficacy and prognostic factors in the treatment of adult newly-diagnosed acute myeloid leukemia (AML) with or without allogeneic hematopoietic stem cell transplantation (Allo-HSCT).Methods We retrospectively analyzed 668 patients with newly-diagnosed AML (non-M3 type) in th...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2024.2310960 |
| _version_ | 1826936802319007744 |
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| author | Jie Ding Yang Su Yinglu Ruan Nan Li Qianchao Meng Jiabang Yang Li Chen Chi Liu |
| author_facet | Jie Ding Yang Su Yinglu Ruan Nan Li Qianchao Meng Jiabang Yang Li Chen Chi Liu |
| author_sort | Jie Ding |
| collection | DOAJ |
| description | Objective To investigate efficacy and prognostic factors in the treatment of adult newly-diagnosed acute myeloid leukemia (AML) with or without allogeneic hematopoietic stem cell transplantation (Allo-HSCT).Methods We retrospectively analyzed 668 patients with newly-diagnosed AML (non-M3 type) in the Department of Hematology at Shanghai Changhai Hospital from January 2012 to December 2021. Based on different induction chemotherapy regimens, patients were categorized into an IA (idarubicin, IDA + cytarabine, Ara-C) (3 + 7, regimen) group (n = 303) and a DA (daunorubicin, DNR + cytarabine, Ara-C) (3 + 7, regimen) group (n = 365) with or without allo-HSCT. Minimal residual disease (MRD), complete response (CR), overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse effects (AE) were analyzed and compared. Characteristics significantly associated with overall or progression-free survival (OS or PFS) upon univariate analysis were subsequently included in a Cox proportional hazard model.Results This study used data from 668 AML patients. After induction therapy, the CR rate in the IA group was 70.63% and ORR was 79.87%, which were significantly higher than those in the DA group (with a CR rate of 56.99% and an ORR of 70.14%) (P = 0.0002 and P = 0.0035, respectively). There were no significant differences in drug safety between the two chemotherapy regimens used in IA and DA (P > 0.05). The recurrence rate was lower in patients with an MRD < 0.001 than in patients with an MRD ≥ 0.001. A continuous negative MRD during the period is significant because it is associated with prolonged OS and PFS of AML patients. Data from 100 patients in the two groups who underwent allo-HSCT were analyzed using univariate analysis and the Cox proportional hazards model. From the multivariate analysis, MRD was found to be the only independent predictor of OS (P = 0.042; HR 1; 95%CI 0.00–0.76).Conclusion In the treatment of adult AML patients, IA regimen is associated with a high CR rate and ORR rate and does not increase treatment-related toxicity. IA regimen prolongs OS and PFS in AML patients and reduces the likelihood of leukemia cells’ subsequent infiltration into the central nervous system. There is a high correlation between the level of MRD after treatment and the patient's bone marrow recurrence. To obtain superior treatment effects for patients undergoing allo-HSCT, the MRD should be reduced to less than 0.001 before pretreatment. A negative MRD before allo-HSCT can prolong OS in patients with AML. We examined the clinical characteristics and outcomes of AML patients in China, finding novel information on prognostic factors and primary treatment of AML that may be applicable in routine clinical practice. |
| first_indexed | 2024-03-08T04:59:47Z |
| format | Article |
| id | doaj.art-cea21db89b044ece9ab4e4ba0ccad935 |
| institution | Directory Open Access Journal |
| issn | 1607-8454 |
| language | English |
| last_indexed | 2025-02-17T18:28:05Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj.art-cea21db89b044ece9ab4e4ba0ccad9352024-12-12T15:08:53ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2310960Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in ChinaJie Ding0Yang Su1Yinglu Ruan2Nan Li3Qianchao Meng4Jiabang Yang5Li Chen6Chi Liu7Department of Hematology, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Hematology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaDepartment of Rehabilitation Medicine, Jing’an District Center Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China,Department of Geriatrics Center & National Clinical Research Center for Aging and Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of ChinaInnovation Research Institute of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaDepartment of Hematology, Changhai Hospital, Naval Military Medical University, Shanghai, People’s Republic of ChinaDepartment of Hematology, Changhai Hospital, Naval Military Medical University, Shanghai, People’s Republic of ChinaDepartment of Geriatrics Center & National Clinical Research Center for Aging and Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of ChinaObjective To investigate efficacy and prognostic factors in the treatment of adult newly-diagnosed acute myeloid leukemia (AML) with or without allogeneic hematopoietic stem cell transplantation (Allo-HSCT).Methods We retrospectively analyzed 668 patients with newly-diagnosed AML (non-M3 type) in the Department of Hematology at Shanghai Changhai Hospital from January 2012 to December 2021. Based on different induction chemotherapy regimens, patients were categorized into an IA (idarubicin, IDA + cytarabine, Ara-C) (3 + 7, regimen) group (n = 303) and a DA (daunorubicin, DNR + cytarabine, Ara-C) (3 + 7, regimen) group (n = 365) with or without allo-HSCT. Minimal residual disease (MRD), complete response (CR), overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse effects (AE) were analyzed and compared. Characteristics significantly associated with overall or progression-free survival (OS or PFS) upon univariate analysis were subsequently included in a Cox proportional hazard model.Results This study used data from 668 AML patients. After induction therapy, the CR rate in the IA group was 70.63% and ORR was 79.87%, which were significantly higher than those in the DA group (with a CR rate of 56.99% and an ORR of 70.14%) (P = 0.0002 and P = 0.0035, respectively). There were no significant differences in drug safety between the two chemotherapy regimens used in IA and DA (P > 0.05). The recurrence rate was lower in patients with an MRD < 0.001 than in patients with an MRD ≥ 0.001. A continuous negative MRD during the period is significant because it is associated with prolonged OS and PFS of AML patients. Data from 100 patients in the two groups who underwent allo-HSCT were analyzed using univariate analysis and the Cox proportional hazards model. From the multivariate analysis, MRD was found to be the only independent predictor of OS (P = 0.042; HR 1; 95%CI 0.00–0.76).Conclusion In the treatment of adult AML patients, IA regimen is associated with a high CR rate and ORR rate and does not increase treatment-related toxicity. IA regimen prolongs OS and PFS in AML patients and reduces the likelihood of leukemia cells’ subsequent infiltration into the central nervous system. There is a high correlation between the level of MRD after treatment and the patient's bone marrow recurrence. To obtain superior treatment effects for patients undergoing allo-HSCT, the MRD should be reduced to less than 0.001 before pretreatment. A negative MRD before allo-HSCT can prolong OS in patients with AML. We examined the clinical characteristics and outcomes of AML patients in China, finding novel information on prognostic factors and primary treatment of AML that may be applicable in routine clinical practice.https://www.tandfonline.com/doi/10.1080/16078454.2024.2310960Acute myeloid leukemiaMRDallogeneic stem cell transplantclinical featuresprognosis |
| spellingShingle | Jie Ding Yang Su Yinglu Ruan Nan Li Qianchao Meng Jiabang Yang Li Chen Chi Liu Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China Hematology Acute myeloid leukemia MRD allogeneic stem cell transplant clinical features prognosis |
| title | Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China |
| title_full | Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China |
| title_fullStr | Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China |
| title_full_unstemmed | Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China |
| title_short | Clinical features and outcomes of patients with acute myeloid leukemia: the single-center experience of 668 patients in China |
| title_sort | clinical features and outcomes of patients with acute myeloid leukemia the single center experience of 668 patients in china |
| topic | Acute myeloid leukemia MRD allogeneic stem cell transplant clinical features prognosis |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2024.2310960 |
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