初发慢性髓性白血病慢性期不同年龄患者临床特征、治疗和结局

OBJECTIVE: To explore the clinical characteristics, treatment patterns, and outcomes in newly diagnosed patients with chronic myeloid leukemia in the chronic phase（CML-CP）by age. METHODS: Clinical data of consecutive ≥14 years old newly diagnosed CML-CP patients were retrospectively analyzed. RESULTS: This study included 957 patients. Of the patients, 597（62.4％）were male. The median age was 40 years（range, 14–83 years）. The patients were stratified into three age groups: <40 years（n＝470; 49.1％）, 40–59 years（n＝371; 38.8％）, and ≥60 years（n＝116; 12.1％）. The proportions of the patients who had splenomegaly（P<0.001）, WBC ≥100 × 10(9)/L（P<0.001）, anemia（P<0.001）, PLT <450 × 10(9)/L（P＝0.022）, more blasts in the blood（P＝0.010）, and clonal chromosome abnormalities in Philadelphia chromosome-positive cells（P＝0.006）at diagnosis significantly decreased with age. However, the proportions of those with comorbidities（P<0.001）, intermediate or high Sokal risk（P<0.001）, and receiving imatinib as front-line therapy（P<0.001）significantly increased with age. No significant differences in gender and the EUTOS Long-Term Survival risks were noted across the three age groups. The multivariate analysis showed that ≥60 years was an adverse predictor for overall survival. However, age was not significantly associated with tyrosine kinase inhibitor（TKI）therapy responses and other outcomes. The incidences of nonhematological toxicity were significantly increased with age during TKI therapy（P<0.001）. However, those of hematological toxicity was similar across the three age groups. The proportions of the patients maintaining imatinib therapy（P＝0.026）and receiving low-dose TKI therapy（P<0.001）significantly increased with age at the end of follow-up. CONCLUSION: Significant differences exist in clinical characteristics, TKI response, overall survival rates, and nonhematological toxicity among newly diagnosed CML-CP patients of different ages.