急性髓性白血病和心血管疾病患者的临床疗效

IF 2.1 4区 医学 Q3 HEMATOLOGY
Gabriela Sanchez-Petitto , Olga G. Goloubeva , Jack Masur , James Childress , Tahreem Iqbal , Max An , Safwan Muhammad , Justin Lawson , Grace Li , Brian Barr , Ashkan Emadi , Jennie Y. Law , Seung Tae Lee , Vu H. Duong , Maria R. Baer , Sandrine Niyongere
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引用次数: 0

摘要

急性髓性白血病(AML)和心血管疾病(CVD)的发病率都会随着年龄的增长而增加。我们评估了原有的心血管疾病是否会影响急性髓性白血病的临床预后。我们回顾性评估了 2014-2020 年在本院接受治疗的 291 例连续成人急性髓细胞白血病患者。通过病历审查确定了治疗前的合并症。研究结果包括完全缓解率(CR)和计数恢复不完全的CR率(CRi)、无病生存率(DFS)、总生存率(OS)以及心血管不良事件的发生率。34%的急性髓细胞性白血病患者在确诊时患有心血管疾病。CVD患者的表现状态较差(p=0.03),更常见的是继发性急性髓细胞性白血病(p=0.03),并接受低甲基化(HMA)药物治疗(72% vs 38%,p< 0.001)。心血管疾病(0.45 vs 0.71,p<0.001)和糖尿病(HR= 0.24,95% CI:0.08 - 0.8,p= 0.01)与达到 CR/CRi 的概率较低有关。考虑到年龄、表现状态(PS)、复杂核型、继发疾病和治疗,CVD患者的OS较短(HR=1.5,95% CI:1.1-2.2,p=0.002),1年和3年OS分别为44% vs 67%和25% vs 40%,但有CVD和无CVD患者的累积复发率没有差异。因此,心血管疾病是导致急性髓细胞性白血病患者反应率降低和生存期缩短的独立风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical outcomes of patients with acute myeloid leukemia and cardiovascular disease

Incidence of both acute myeloid leukemia (AML) and cardiovascular disease (CVD) increases with age. We evaluated whether pre-existing CVD impacts clinical outcomes in AML. We retrospectively evaluated 291 consecutive adult AML patients treated at our institution, 2014–2020. Pretreatment comorbidities were identified by chart review. Outcomes included complete remission (CR) and CR with incomplete count recovery (CRi) rates, disease-free survival (DFS), overall survival (OS) and incidence of cardiovascular adverse events. CVD was present in 34% of patients at AML diagnosis. CVD patients had worse performance status (p=0.03) and more commonly had secondary AML (p=0.03) and received hypomethylating (HMA) agent-based therapy (72% vs 38%, p< 0.001). CVD (0.45 vs 0.71, p<0.001) and diabetes mellitus (HR= 0.24, 95% CI: 0.08 – 0.8, p= 0.01) were associated with lower probability of achieving CR/CRi. Accounting for age, performance status (PS), complex karyotype, secondary disease and treatment, CVD patients had shorter OS (HR=1.5, 95% CI: 1.1–2.2, p=0.002), with 1- and 3-year OS 44% vs 67% and 25% vs 40%, respectively, but there was no difference in cumulative incidence of relapse between patients with vs without CVD. Thus, CVD is an independent risk factor for lower response rate and shorter survival in AML patients.

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来源期刊
Leukemia research
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.
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