Outcome of adolescents and young adult acute myeloid leukemia patients compared with middle-aged patients: A single centre retrospective experience

IF 2.1 4区医学 Q3 HEMATOLOGY Leukemia research Pub Date : 2024-09-21 DOI:10.1016/j.leukres.2024.107586

RuiQi Chen, Mohaned AlHumaid, Georgina Daher-Reyes, Eshetu G. Atenafu, Steven Chan, Vikas Gupta, Dawn Maze, Andre C. Schuh, Mark D. Minden, Karen Yee, Aaron D. Schimmer, Hassan Sibai

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Abstract

Adult acute myeloid leukemia (AML) patients under the age of 60 often receive similar intensive treatments, while outcomes between the adolescent and young adult (AYA) age group (18−39) and middle-aged adults (40–60 years) were seldom reported. We aim to study the characteristics and outcomes of AYA patients in comparison to middle-aged adults. A retrospective analysis was performed on AYA patients treated at Princess Margaret Cancer Center between 2008 and 2018. The primary outcomes include overall survival (OS), cumulative incidence of relapse (CIR), and non-relapse mortality (NRM).

A total of 174 AYA patients and 176 middle-aged patients were included, with propensity score matching adjusting for potential major confounders. Comparing AYA and middle-aged patients, 5-year OS rates were similar at 54.6 % vs. 56.5 % (p=0.91), CIR rates at 29.5 % vs. 23.1 % (p=0.31), and similar NRM rates. Notably, non-transplanted AYA patients had a significantly higher CIR (39.8 %) compared to middle-aged patients (19.6 %) (p=0.0324), with more primary refractory/early relapsing disease. An observed trend toward improved OS in AYA patients post-2015 coincided with FLAG-IDA and haploidentical transplant implementations.

In conclusion, the study suggests that AYA patients, particularly those not undergoing transplantation, may benefit from more intensive treatment strategies, emphasizing the need for tailored approaches in this age group.

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青少年和年轻成人急性髓性白血病患者与中年患者的预后比较：单一中心的回顾性经验。

60 岁以下的成人急性髓性白血病（AML）患者通常会接受类似的强化治疗，而青少年和年轻成人（AYA）年龄组（18-39 岁）与中年成人（40-60 岁）之间的治疗效果却鲜有报道。我们旨在研究青少年和青年患者与中年人相比的特征和疗效。我们对 2008 年至 2018 年期间在玛格丽特公主癌症中心接受治疗的青壮年患者进行了回顾性分析。主要结果包括总生存期（OS）、累积复发率（CIR）和非复发死亡率（NRM）。共纳入174名青壮年患者和176名中年患者，并对潜在的主要混杂因素进行倾向评分匹配调整。对比青壮年患者和中年患者，5年OS率相似，分别为54.6%和56.5%（P=0.91），CIR率分别为29.5%和23.1%（P=0.31），NRM率相似。值得注意的是，与中年患者（19.6%）相比，未接受移植的青壮年患者的CIR（39.8%）明显更高（p=0.0324），原发性难治/早期复发的疾病也更多。2015年后，随着FLAG-IDA和单倍体移植的实施，观察到AYA患者的OS呈改善趋势。总之，该研究表明，AYA 患者，尤其是未接受移植的患者，可能会从更密集的治疗策略中获益，这也强调了在这一年龄组中采取针对性治疗方法的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Leukemia research 医学-血液学

CiteScore

4.00

自引率

3.70%

发文量

259

审稿时长

1 months

期刊介绍： Leukemia Research an international journal which brings comprehensive and current information to all health care professionals involved in basic and applied clinical research in hematological malignancies. The editors encourage the submission of articles relevant to hematological malignancies. The Journal scope includes reporting studies of cellular and molecular biology, genetics, immunology, epidemiology, clinical evaluation, and therapy of these diseases.