NONE PROMYELOCYTIC AML TREATED WITH IDA OR DNR OBSERVATION
Description
To verify the superiority of idarubicin to daunorubicin in the field of respond on initial induction of none promyelocytic AML in the real world practices of Zhujiang hospital hematology department and investigate other clinical characteristics corelated with long term survive in these patients, the information of such patients who had at lest once of hospitalization in zhujiang hospital from Jan. 2019 to Sept. 2021 were collected. The complete remission rate of idarubicin included "3+7" regimen was significantly higher than that of daunorubicin included regimen after the initial induction. But the induction regimen was not independently corelated with induction remission. The cytogenetic risk classification and gender were the factors relating to remission with sitatistical significancy. The OS and PFS both significantly corelated with stem cell transplantation, meanwhile OS also significantly corelated with chemotherapy refractory feature. To those none favourable cytogenetic risk classified patients who had underwent transplantation, onset age was the only statistically independent factor corelated with OS, PFS and even time to relapse after transplantation. But we also found the initial induction regimen was another independent factor associated with relapse time after transplantation. The data told us in the real world practices, idarubicin induction was a better regimen to induct remission than daunorubicin in newly diagnosed none promyelocytic AML especially in the none favourable risk group or female group. But the long term survive of none promyelocytic AML more depended on later acceptance of transplantation or none chemotherapy refractory respondance. For those none favourable risk patients with transplantation, older onset age was still an unfavourable predictive factor to long term survive and idarubicin induction was a favourable predictive factor to postpone relapse after transplantation.
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Patients’ cast were acquired by searching the diagnosis of acute myeloid leukemia in Jiahe electronic history record platform of inpatient used in Zhujiang hospital. Acute promyelocytic leukemia patients were excluded. The information of patients’ general characteristics, diagnosis, treatment, respond and followup status were deposited in the history and collected by the doctors in charge in a comprehensive document obeying a rule with consent. Jiahe electronic history platform was a software provided by the Beijing Jiahe general electric limited company and was built in Zhujiang hospital since Jun. 2008. The patients’ cast was screened on the premise of time ranging from Jan. 2019 to Sept. 2021 and diangnosis mentioned above. Most patients’ features were recorded in the history or outpatient record and easily to be retrieved. Cytogenetic classification were evaluated again by the doctors in charge according to the criteria published on 2016 NCCN clinical practice guidelines for AML. Other information including myelosuppression features like fibrile neutropenia days and upper respiratory infections during the first induction were decided by the patient’s doctor in charge. Death event were recorded in the history and we followed up the patients' living status via telephone connection of themselves or their close relatives. The SPSS data doctument were formed from the raw data above and used for statistic analysis.