Comparative analysis of causes and predictors of early death in elderly and young patients with acute promyelocytic leukemia treated with arsenic trioxide.

Abstract

PURPOSE:

Early death (ED) is the main cause of acute promyelocytic leukemia (APL) treatment failure, and the ED rate is higher for elderly patients than that for young ones. To date, no studies have been found focusing on ED in elderly patients with APL.

METHODS:

This study retrospectively analyzed the clinical data of 409 consecutive patients with APL (139 patients ≥ 50 years old, 270 patients < 50 years old). All patients received arsenic trioxide alone as induction therapy. The baseline clinical characteristics and ED occurrence and predictors between elderly and young patients with APL were compared and analyzed.

RESULTS:

The clinical features of elderly patients at admission were not significantly different from those of young ones. The ED rate of elderly patients was significantly greater than that of young patients (23.74% vs 11.85%, P = 0.0018). Hemorrhage is the main cause of ED in elderly patients, followed by infection and differentiation syndrome. From the 15th to 30th days of treatment, elderly patients had a higher mortality rate than that of young patients (7.83% vs 2.06%, P = 0.009). Male, white blood cell (WBC) count > 10 × 109/L, fibrinogen < 1.0 g/L and low albumin levels were independent risk factors for ED in elderly patients, while ED was only correlated with WBC count, fibrinogen and creatinine levels in young patients.

CONCLUSION:

The results of this study may help design more rational treatment plans for elderly patients with APL based on early mortality risk to reduce the ED rate.

• Authors: Bo Jin, Yingmei Zhang, Wenyi Hou, Fenglin Cao, Ming Lu, Huiyuan Yang, Xuanyu Tian, Yuan Wang, Jinxiao Hou, Jinyue Fu, Haitao Li, Jin Zhou
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 146 Issue 2 Pg. 485-492 (Feb 2020) ISSN: 1432-1335 [Electronic] Germany
• PMID: 31686248 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antineoplastic Agents
• Arsenic Trioxide

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Arsenic Trioxide (therapeutic use)
• Child
• Female
• Humans
• Leukemia, Promyelocytic, Acute (drug therapy, mortality)
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Young Adult