Table 4.
Factors associated with risk of death among AML patients (clinical cohort)
| APL patients (n = 27) | non-APL AML patients (n = 331) | |||||||
|---|---|---|---|---|---|---|---|---|
| Hazard ratio (95% confidence interval)b | Hazard ratio (95% confidence interval)b | |||||||
| Characteristic | N (%)a | Median survival (days) | Unadjusted | Adjustedc | N (%)a | Median survival (days) | Unadjusted | Adjustedc |
| Age category (years) | ||||||||
| ≥63 | 7 (25.9) | 1588 | 5.60 (0.51–61.78) | 1.62 (0.14–18.31) | 167 (50.5) | 138 | *1.85 (1.40–2.44) | *1.80 (1.34–2.41) |
| <63 | 20 (74.1) | 808 | 1.0 (ref) | 1.0 (ref) | 164 (49.5) | 325 | 1.0 (ref) | 1.0 (ref) |
| Gender | ||||||||
| Male | 13 (48.2) | 766 | NE | NE | 169 (51.1) | 205 | 1.31 (0.99–1.71) | 1.26 (0.94–1.68) |
| Female | 14 (51.9) | 965 | 1.0 (ref) | 1.0 (ref) | 162 (48.9) | 270 | 1.0 (ref) | 1.0 (ref) |
| Race | ||||||||
| Non-white | 11 (44.0) | 1019 | 2.51 (0.23–27.72) | 2.56 (0.15–43.29) | 149 (48.2) | 249 | 0.84 (0.63–1.12) | 0.92 (0.68–1.24) |
| White | 14 (56.0) | 740 | 1.0 (ref) | 1.0 (ref) | 160 (51.8) | 243 | 1.0 (ref) | 1.0 (ref) |
| Ethnicity | ||||||||
| Hispanic | 6 (23.1) | 752 | NE | NE | 58 (19.2) | 250 | 0.87 (0.60–1.27) | 0.96 (0.65–1.42) |
| Non-Hispanic | 20 (76.9) | 838 | 1.0 (ref) | 1.0 (ref) | 244 (80.8) | 252 | 1.0 (ref) | 1.0 (ref) |
| Type of AML | ||||||||
| Secondary | 3 (11.1) | 198 | *17.32 (1.56–192.1) | NE | 133 (40.8) | 138 | *1.96 (1.49–2.58) | 1.32 (0.91–1.92) |
| De novo | 24 (88.9) | 880 | 1.0 (ref) | 1.0 (ref) | 193 (59.2) | 311 | 1.0 (ref) | 1.0 (ref) |
| ELN category | ||||||||
| Unfavorable | N/A | N/A | N/A | N/A | 99 (83.9) | 122 | *2.93 (1.27–6.79) | *4.10 (1.46–11.55) |
| Favorable | N/A | N/A | N/A | N/A | 19 (16.1) | 461 | 1.0 (ref) | 1.0 (ref) |
| Complex karyotype | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 37 (35.6) | 67 | *2.56 (1.55–4.22) | *2.33 (1.29–4.21) |
| No | 6 (100) | — | 1.0 (ref) | 1.0 (ref) | 67 (64.4) | 192 | 1.0 (ref) | 1.0 (ref) |
| Prior cancer therapy | ||||||||
| Yes | 4 (15.4) | 156 | NE | NE | 85 (26.2) | 137 | *2.00 (1.49–2.67) | 1.04 (0.71–1.53) |
| No | 22 (84.6) | 965 | 1.0 (ref) | 1.0 (ref) | 239 (73.8) | 290 | 1.0 (ref) | 1.0 (ref) |
| Prior radiotherapyc | ||||||||
| Yes | 1 (25.0) | 1990 | NE | NE | 27 (31.8) | 171 | 0.86 (0.50–1.47) | 0.67 (0.37–1.22) |
| No | 3 (75.0) | 114 | 1.0 (ref) | 1.0 (ref) | 58 (68.2) | 131 | 1.0 (ref) | 1.0 (ref) |
| Prior chemotherapyc | ||||||||
| Yes | 3 (75.0) | 198 | NE | NE | 67 (78.8) | 125 | 1.16 (0.63–2.14) | 1.44 (0.72–2.87) |
| No | 1 (25.0) | 11 | 1.0 (ref) | 1.0 (ref) | 18 (21.2) | 185 | 1.0 (ref) | 1.0 (ref) |
| Prior radio and chemotherapyc | ||||||||
| Yes | 1 (25.0) | 1990 | NE | NE | 14 (16.5) | 114 | 1.22 (0.63–2.34) | 1.12 (0.57–2.12) |
| No | 3 (75.0) | 114 | 1.0 (ref) | 1.0 (ref) | 71 (83.5) | 158 | 1.0 (ref) | 1.0 (ref) |
| Chemotherapeutic agentc | ||||||||
| Alkylating agent | ||||||||
| Yes | 3 (75.0) | 198 | NE | NE | 19 (22.4) | 119 | 0.84 (0.44–1.58) | 0.90 (0.47–1.72) |
| No | 1 (25.0) | 11 | 1.0 (ref) | 1.0 (ref) | 66 (77.6) | 145 | 1.0 (ref) | 1.0 (ref) |
| Topoisomerase II | ||||||||
| Yes | 3 (75.0) | 198 | NE | NE | 7 (8.2) | 304 | 0.46 (0.14–1.48) | 0.54 (0.16–1.77) |
| No | 1 (25.0) | 11 | 1.0 (ref) | 1.0 (ref) | 78 (91.8) | 133 | 1.0 (ref) | 1.0 (ref) |
| Antimetabolite | ||||||||
| Yes | 1 (25.0) | 198 | 0.88 (0.08–10.26) | 0.45 (0.02–10.74) | 14 (16.5) | 146 | 0.79 (0.37–1.66) | 0.91 (0.42–1.96) |
| No | 3 (75.0) | 114 | 1.0 (ref) | 1.0 (ref) | 71 (83.5) | 137 | 1.0 (ref) | 1.0 (ref) |
| Antitubulin | ||||||||
| Yes | 1 (25.0) | 114 | 2.45 (0.15–39.72) | 2.21 (0.09–52.23) | 10 (11.8) | 24 | *2.57 (1.26–5.26) | *3.30 (1.49–7.32) |
| No | 3 (75.0) | 198 | 1.0 (ref) | 1.0 (ref) | 75 (88.2) | 166 | 1.0 (ref) | 1.0 (ref) |
| Other agent | ||||||||
| Yes | 1 (25.0) | 114 | 2.45 (0.15–39.72) | 2.21 (0.09–52.23) | 44 (51.8) | 139 | 1.23 (0.74–2.04) | 1.26 (0.74–2.17) |
| No | 3 (75.0) | 198 | 1.0 (ref) | 1.0 (ref) | 41 (48.2) | 137 | 1.0 (ref) | 1.0 (ref) |
| Specific genetic mutations | ||||||||
| ASXL1 | ||||||||
| Yes | 0 (0.0) | NE | NE | 5 (2.8) | 232 | 1.69 (0.69–4.11) | 1.73 (0.71–4.25) | |
| No | 11 (100) | 1.0 (ref) | 1.0 (ref) | 175 (97.2) | 243 | 1.0 (ref) | 1.0 (ref) | |
| FLT3 | ||||||||
| Yes | 5 (45.5) | 169 | *11.7 (1.03–134.5) | NE | 42 (23.3) | 317 | 0.77 (0.50–1.20) | 1.03 (0.65–1.61) |
| No | 6 (54.5) | 1041 | 1.0 (ref) | 1.0 (ref) | 138 (76.7) | 223 | 1.0 (ref) | 1.0 (ref) |
| DNMT3A | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 15 (8.3) | 273 | 0.91 (0.43–1.94) | 1.17 (0.55–2.52) |
| No | 11 (100) | — | 1.0 (ref) | 1.0 (ref) | 165 (91.7) | 240 | 1.0 (ref) | 1.0 (ref) |
| RUNX1 | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 10 (5.6) | 208 | 1.16 (0.42–3.18) | 1.51 (0.54–4.19) |
| No | 11 (100) | — | 1.0 (ref) | 1.0 (ref) | 170 (94.4) | 312 | 1.0 (ref) | 1.0 (ref) |
| TET2 | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 15 (8.3) | 194 | 1.05 (0.52–2.14) | 1.09 (0.54–2.23) |
| No | 11 (100) | — | 1.0 (ref) | 1.0 (ref) | 165 (91.7) | 243 | 1.0 (ref) | 1.0 (ref)f |
| TP53 | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 7 (3.9) | 196 | 1.65 (0.60–4.50) | 1.27 (0.46–3.54) |
| No | 11 (100) | — | 1.0 (ref) | 1.0 (ref) | 173 (96.11) | 311 | 1.0 (ref) | 1.0 (ref) |
| PHF6 | ||||||||
| Yes | 0 (0.0) | — | NE | NE | 1 (0.6) | 367 | 1.67 (0.23–12.05) | 1.24 (0.16–9.41) |
| No | 11 (100) | — | 1.0 (ref) | 1.0 (ref) | 179 (99.4) | 309 | 1.0 (ref) | 1.0 (ref) |
N/A: Not applicable since ELN category is not defined for APL patients.
NE: Not estimable due to small numbers in strata and/or too few or no events (deaths).
aNumber of patients for whom survival data are available.
bCox proportional hazards regression model.
cModel adjusted for age category, gender, ethnicity and prior cancer therapy. For specific types of cancer therapy, model adjusted for age, gender and ethnicity.
*P ≤ 0.05.