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  

he prognosis value of comprehensive geriatric assessment in elder patients with acute myeloid leukemia in a single center

作　　者：白洁菲[1] 梅迪[1] 韩惠秀 张帅[1] 冯茹[1] 李江涛[1] 王婷[1] 张春丽[1] 宁尚勇[1] 刘辉[1] Bai Jiefei;Mei Di;Han Huixiu;Zhang Shuai;Feng Ru;Li Jiangtao;Wang Ting;Zhang Chunli;Ning Shangyong;Liu Hui(Department of Hematology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China)

机构地区：[1]北京医院血液科、国家老年医学中心,100730

出　　处：《中华血液学杂志》2019年第3期200-203,共4页Chinese Journal of Hematology

摘　　要：目的评价综合老年学评估(CGA)在老年急性髓系白血病(AML)患者中预后价值。方法纳入73例北京医院诊断的年龄≥ 60岁的AML患者,CGA评估选取日常活动功能量表、工具性日常活动功能量表以及改良老年疾病累计评分表。以评分量表及患者年龄为标准,将患者分为适合、不适合以及脆弱组。结果 73例患者中男46例,女27例,中位年龄75(60~89)岁。适合组37例(50.1%),不适合组14例(19.2%),脆弱组22例(30.7%),三组分别有33例(89.2%)、8例(57.1%)、10例(45.5%)患者接受化疗(标准化疗或去甲基化治疗),三组患者总反应率分别为68.7%、62.5%、75.0%(χ^2=0.615,P=0.769)。适合组、不适合组、脆弱组的早期死亡率(8周死亡率)分别为5.4%、7.1%、27.3%(P<0.05),1年预计总生存率分别为64.9%、28.6%、22.7%(P<0.05)。单因素生存分析显示CGA评分、年龄、ECOG评分、WHO分型(2016)均是影响AML患者生存时间的因素(P<0.05)。结论 CGA可预测老年AML患者的早期死亡率及远期生存。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.

关 键 词：白血病 髓系 急性 老年 综合老年学评估 预后 

分 类 号：R733.71[医药卫生—肿瘤]