The clinical features and outcomes of elderly patients with acute myeloid leukemia: a real word research

The aim of this study was to investigate the clinical features and outcomes of elderly patients with acute myeloid leukemia (AML) from a real word research. The clinical data of 223 consecutive elderly patients (aged ≥ 60 years) who were newly diagnosed with AML at our medical center between July 2017 and June 2022, including their clinical characteristics, genetic mutations, and survival outcomes, were retrospectively analyzed. Among the 223 patients (median age 67 years), 180 (80.7%) were diagnosed with de novo AML. Genetic mutations were identified in 138 of 149 patients tested (92.6%). The most commonly mutated genes included TET2, DNMT3A, NPM1, FLT3-ITD, ASXL1, IDH2, RUNX1, TP53, and CEBPA. Among these genes, TET2, DNMT3A, FLT3-ITD, and TP53 were associated with a poor outcome. Multivariate Cox's regression analysis revealed that age over 70 years, platelet count less than 100 × 10⁹/L, albumin level less than 35 g/L, presence of infection or bleeding at diagnosis, untreated or best supportive care (BSC) treatment status, and adverse or intermediate ELN 2022 risk classification were independent prognostic factors for overall survival in elderly AML patients. Patients who received at least one induction cycle had longer overall survival times (20 months vs. 6.6 months, P < 0.001) than those who received best supportive care. Patients with ≥ 6 cycles of chemotherapy had longer overall survival times (89.2% vs. 78.5%, P = 0.007) than those with ≤ 5 cycles of therapy. The results of this study indicated that elderly AML patients had multiple genetic abnormalities and poor outcomes. Regular effective treatment can improve patient outcomes and survival. In addition to genetic abnormalities, several other clinical features can influence survival in elderly AML patients.