Comorbidity is an independent predictor of complete remission in elderly patients receiving induction chemotherapy for acute myeloid leukemia

Authors:
Open Access
Publisher website
Google Scholar
Abstract
BACKGROUND.: Elderly patients with acute myeloid leukemia (AML) have a poor prognosis, which is explained by the disease itself and by host‐related factors. The objective of this study was to determine the prognostic role of comorbidities in this population.METHODS.: For this single‐center, retrospective study, the authors analyzed the outcome of 133 patients aged ≥70 years who received induction chemotherapy for nonpromyelocytic AML between 1995 and 2004. Comorbidities were evaluated by using an adapted form of the Charlson comorbidity index (CCI).RESULTS.: The median patient age was 73 years. The CCI score was 0 for 83 patients (68%), 1 for 16 patients (13%), and >1 for 23 patients (19%). The complete remission (CR) rate was 56%, and the median overall survival was 9 months. In multivariate analysis, 4 adverse prognostic factors for CR were identified: unfavorable karyotype, leukocytosis ≥30 g/L, CD34 expression on leukemic cells, and CCI >1. A score could be generated to allow the stratification of patients into low‐, intermediate‐, and high‐risk groups with CR rates of 87%, 63%, and 37%, respectively. The risk of early mortality and the probability of survival also were different in the 3 risk groups (P = .02 and P = .01, respectively).CONCLUSIONS.: The results from this study indicated that associated comorbidities are independent factors that may influence achievement of CR in elderly patients with AML. Such a scoring system may be useful in the prognostic staging systems that are used to identify patients with AML who can benefit from induction chemotherapy. Cancer 2007. © 2007 American Cancer Society.

This publication has 34 references indexed in Scilit: