The risk of early mortality in elderly patients with newly diagnosed acute myeloid leukemia

• Published in: Cancer medicine (Malden, MA) MA), 2020-02, Vol.9 (4), p.1572-1580
• Main Authors: Liu, Chia‐Jen, Hong, Ying‐Chung, Kuan, Ai Seon, Yeh, Chiu‐Mei, Tsai, Chun‐Kuang, Liu, Yao‐Chung, Hsiao, Liang‐Tsai, Wang, Hao‐Yuan, Ko, Po‐Shen, Chen, Po‐Min, Liu, Jin‐Hwang, Gau, Jyh‐Pyng
• Format: Article
• Language: English
• Subjects: Acute myeloid leukemia; Age; Age Factors; Aged; Aged, 80 and over; Blood; Bone marrow; Bone Marrow - pathology; Cancer Prevention; Cytogenetics; Data collection; Diabetes; early mortality; elderly; epidemiology; Epidermal growth factor receptors; Female; Follow-Up Studies; Geriatrics; Glomerular Filtration Rate; Health risk assessment; Heart attacks; Hemoglobin; Hospitals; Humans; Hypertension; Kaplan-Meier Estimate; Karyotypes; Karyotyping; Leukemia; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - pathology; Male; Medical records; Middle Aged; Mortality; Multivariate analysis; Myeloid leukemia; Myocardial infarction; Myocardial Infarction - epidemiology; Original Research; Prognosis; prognostic models; Retrospective Studies; Risk Assessment - statistics & numerical data; Risk Factors; Software; Statistical analysis; Survival analysis; Ulcers
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.2740

Background Acute myeloid leukemia (AML) is a common hematologic neoplasm with high incidence and mortality in the elderly. Our aims were to explore risk factors for early mortality in elderly AML patients and develop a new prognostic score. Methods We enrolled newly diagnosed AML patients age 60 and above at Taipei Veterans General Hospital between July 2008 and May 2017. The primary endpoint was early mortality, defined as death within two months after AML diagnosis. A multivariate Cox proportional hazards model was used to build a risk‐scoring system incorporating significant risk factors for AML. Results The final cohort included 277 elderly AML patients. The median age was 74 (range 60‐96), and 61.7% were male. The two‐month mortality rate was 29.9%. Age ≥ 80 (adjusted HR 1.88), myocardial infarction (adjusted HR 1.87), ECOG ≥ 2 (adjusted HR 2.10), complex karyotype (adjusted HR 3.21), bone marrow blasts ≥ 70% (adjusted HR 1.88), WBC ≥ 100 × 109/L (adjusted HR 3.31), and estimated glomerular filtration rate (eGFR)