综合老年学评估对老年急性髓系白血病患者的预后价值的单中心研究

OBJECTIVE: To evaluate the prognostic significance of comprehensive geriatric assessment (CGA) in Chinese elderly acute myeloid leukemia (AML) patients. METHODS: 73 AML patients over the age of 60 were enrolled. CGA stratification included the following 3 instrument assessment: activity of daily living (ADL) ; instrumental activity of daily living (IADL) ; comorbidity score according to the Modified cumulative illness rating score for geriatrics (MCIRS-G). According to CGA and age, the enrolled patients were grouped into ‘fit’, ‘unfit’ and ‘frail’ categories. RESULTS: The median age of 73 elderly AML patients were 75 years old. According to CGA, 37 (50.1%) patients were classified as ‘fit’, 14 (19.2%) as ‘unfit’, and 22 (30.7%) as ‘frail’. 33 (89.2%) patients in fit group received induction chemotherapy, or demethylation treatment, as 8 (57.9%) in unfit, 10 (45.5%) in frail. The overall response rate was 68.7%、62.5%, 75.0% in fit, unfit, and frail group, respectively (χ(2)=0.615, P=0.769). The early mortality (8 weeks) in three groups were different: 5.4%, 7.1%, 27.3%, respectively (P<0.05). The 1-year overall survival in the ‘fit’, ‘unfit’ and ‘frail’ groups was 64.9%, 28.6% and 22.7%, respectively (P<0.05). The CGA score, age, ECOG score, WHO classification (2016) were the prognostic factors of AML patients. CONCLUSION: CGA can be used to determine the prognosis of elderly AML patients.