High incidence of unfavorable cytogenetic aberrations and low remission rate in adults over 60 with acute myeloid leukemia
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Дата
2012-06
Автори
Velizarova, M.
Hadzhiev, E.
Dimova, I.
Toncheva, D.
Tsatchev, K.
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Издател
Централна медицинска библиотека, МУ София / Central Medical Library - MU Sofia
Резюме
Adults over 60 years of age with acute myeloid leukemia (AML) more frequently have unfavorable molecular-cytogenetic aberrations, poor response to chemotherapy and higher mortality rate than younger patients. The aim of the study was to analyze the clinical, molecular-cytogenetic and induction treatment response features of adult patients over 60 years of age with newly diagnosed AML. Seventy-seven adults (over 18 years of age) with AML were enrolled
in our 3-year study. Molecular-cytogenetic aberrations, remission rates, resistant
disease and early deaths were compared in the three patient groups: 18-34, 35-59
and 60 years of age or older. Our results confi rmed the generally poor outcome of
the older AML patients. Patients over 60 had a higher percentage (32%, p = 0.03) of unfavorable cytogenetic abnormalities (i.e., chromosome 5 and 7 abnormalities,
t(11q23)/MLL and complex karyotypes) and a lower percentage (3.6%, p = 0.03)
of favorable cytogenetic abnormalities (only 1 patient over 60 with t(15; 17)) than
younger patients. Out of all AML cases, complete remission following initial induction chemotherapy was achieved in 41 (53.2%). The adults over 60 had the lowest
complete remission rate – 35.7% (p < 0.01) and the highest rates of primary chemotherapy-resistant disease (28.5%, p = 0.03) and early deaths (53.6%, p < 0.01),
compared to younger patients. We concluded that high frequency of unfavorable
cytogenetic aberrations and adverse age were major determinants of complete remission rate in intensively treated acute myeloid leukemia patients older than 60 years. These data confirmed the need of an age-specifi c management for the disease in the elderly.
Описание
Address for correspondence:
Milena Velizarova, PhD, MD
Department of Clinical Laboratory and Clinical Immunology
University Hospital “Alexandrovska”;
1 G. Sofiyski str.;
1431 Sofia, Bulgaria;
tel: +359 2 92 30 916 ;
e-mail: mvelizarova@abv.bg
Ключови думи
acute myeloid leukemia, cytogenetics, age, treatment
Цитирания
M. Velizarova, E. Hadzhiev, I. Dimova, D. Toncheva and K. Tsatchev. High incidence of unfavorable cytogenetic aberrations and low remission rate in adults over 60 with acute myeloid leukemia - Acta medica bulgarica , 39, 2012, No 2, 29-36.