The value of comorbidity for stratification of an acute myeloid leukemias treatment in adults
DOI:
https://doi.org/10.15587/2313-8416.2015.45466Keywords:
acute myeloid leukemia, prognosis, treatment stratification, comorbidity, Charlson index, survivabilityAbstract
The aim of research is to define an impact of comorbidity on an effectiveness of an AML treatment and general and recurrence-free survivability
Materials and methods. For solving this problem we analyzed medical histories of 97 patients with AML. Charlson index of comorbidity was used for defining an occurrence and severity of the contaminant pathology in patients with AML. The sum value of the number and severity of the contaminant diseases that is equal to 0 – 2, 3 – 5 points and more than 5 points corresponded to the low, intermediate or a high index of comorbidity. 2 types of an inductive chemotherapy were carried out as a first line: the courses «7+3» and FLAG that defined 2 groups of observation.
Results and discussion. In the group of patients who were treated by the FLAG scheme were twice more patients with a low comorbidity index (0-2 points) (62 % opposite 31 %). The best general and recurrence-free survivability was ascertained in patients with a low comorbidity index (0-2 point)s and at presence of cytogenetic anomalies corresponding to the group of favorable prognosis. Moreover it was established that patients received an inductive chemotherapy (CT) by the FLAG system have a lower risk of recurrence or progression of AML.
Conclusions. The high comorbidity index is a significant risk of recurrence or AML progression, reliably increases risk of death and worsens general and recurrence-free survivability. At AML treatment stratification with a glance to comorbidity index the prognosis of disease and general survivability increases
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