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Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia

The therapeutic strategies for acute myeloid leukemia (AML) patients ineligible for remission induction chemotherapy have been improving in the past decade. Therefore, it is important to define ineligibility for remission induction chemotherapy. We retrospectively assessed 153 consecutive adult de n...

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Autores principales: Li, You-Cheng, Shih, Yu-Hsuan, Chen, Tsung-Chih, Gau, Jyh-Pyng, Su, Yu-Chen, Chen, Mei-Hui, Hsu, Chiann-Yi, Liao, Cai-Sian, Teng, Chieh-Lin Jerry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708870/
https://www.ncbi.nlm.nih.gov/pubmed/34945065
http://dx.doi.org/10.3390/jcm10245768
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author Li, You-Cheng
Shih, Yu-Hsuan
Chen, Tsung-Chih
Gau, Jyh-Pyng
Su, Yu-Chen
Chen, Mei-Hui
Hsu, Chiann-Yi
Liao, Cai-Sian
Teng, Chieh-Lin Jerry
author_facet Li, You-Cheng
Shih, Yu-Hsuan
Chen, Tsung-Chih
Gau, Jyh-Pyng
Su, Yu-Chen
Chen, Mei-Hui
Hsu, Chiann-Yi
Liao, Cai-Sian
Teng, Chieh-Lin Jerry
author_sort Li, You-Cheng
collection PubMed
description The therapeutic strategies for acute myeloid leukemia (AML) patients ineligible for remission induction chemotherapy have been improving in the past decade. Therefore, it is important to define ineligibility for remission induction chemotherapy. We retrospectively assessed 153 consecutive adult de novo AML patients undergoing remission induction chemotherapy and defined early mortality as death within the first 60 days of treatment. The 153 patients were stratified into the early mortality group (n = 29) and the non-early mortality group (n = 124). We identified potential factors to which early mortality could be attributed, investigated the cumulative incidence of early mortality for each aspect, and quantified the elements. The early mortality rate in our study cohort was 19.0%. Age ≥ 65 years (odds ratio (OR): 3.15; 95% confidence interval (CI): 1.05–9.44; p = 0.041), Eastern Cooperative Oncology Group performance status ≥ 2 (OR: 4.87; 95% CI: 1.77–13.41; p = 0.002), and lactate dehydrogenase ≥ 1000 IU/L (OR: 4.20; 95% CI: 1.57–11.23; p = 0.004) were the risk factors that substantially increased early mortality in AML patients. Patients with two risk factors had a significantly higher early mortality rate than those with one risk factor (68.8% vs. 20.0%; p < 0.001) or no risk factors (68.8% vs. 9.2%; p < 0.001). In conclusion, older age, poor clinical performance, and a high tumor burden were risks for early mortality in AML patients receiving remission induction chemotherapy. Patients harboring at least two of these three factors should be more carefully assessed for remission induction chemotherapy.
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spelling pubmed-87088702021-12-25 Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia Li, You-Cheng Shih, Yu-Hsuan Chen, Tsung-Chih Gau, Jyh-Pyng Su, Yu-Chen Chen, Mei-Hui Hsu, Chiann-Yi Liao, Cai-Sian Teng, Chieh-Lin Jerry J Clin Med Article The therapeutic strategies for acute myeloid leukemia (AML) patients ineligible for remission induction chemotherapy have been improving in the past decade. Therefore, it is important to define ineligibility for remission induction chemotherapy. We retrospectively assessed 153 consecutive adult de novo AML patients undergoing remission induction chemotherapy and defined early mortality as death within the first 60 days of treatment. The 153 patients were stratified into the early mortality group (n = 29) and the non-early mortality group (n = 124). We identified potential factors to which early mortality could be attributed, investigated the cumulative incidence of early mortality for each aspect, and quantified the elements. The early mortality rate in our study cohort was 19.0%. Age ≥ 65 years (odds ratio (OR): 3.15; 95% confidence interval (CI): 1.05–9.44; p = 0.041), Eastern Cooperative Oncology Group performance status ≥ 2 (OR: 4.87; 95% CI: 1.77–13.41; p = 0.002), and lactate dehydrogenase ≥ 1000 IU/L (OR: 4.20; 95% CI: 1.57–11.23; p = 0.004) were the risk factors that substantially increased early mortality in AML patients. Patients with two risk factors had a significantly higher early mortality rate than those with one risk factor (68.8% vs. 20.0%; p < 0.001) or no risk factors (68.8% vs. 9.2%; p < 0.001). In conclusion, older age, poor clinical performance, and a high tumor burden were risks for early mortality in AML patients receiving remission induction chemotherapy. Patients harboring at least two of these three factors should be more carefully assessed for remission induction chemotherapy. MDPI 2021-12-09 /pmc/articles/PMC8708870/ /pubmed/34945065 http://dx.doi.org/10.3390/jcm10245768 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, You-Cheng
Shih, Yu-Hsuan
Chen, Tsung-Chih
Gau, Jyh-Pyng
Su, Yu-Chen
Chen, Mei-Hui
Hsu, Chiann-Yi
Liao, Cai-Sian
Teng, Chieh-Lin Jerry
Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title_full Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title_fullStr Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title_full_unstemmed Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title_short Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
title_sort redefining remission induction chemotherapy ineligibility by early mortality in de novo acute myeloid leukemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708870/
https://www.ncbi.nlm.nih.gov/pubmed/34945065
http://dx.doi.org/10.3390/jcm10245768
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