Table 2.
Risk factors for early mortality in elderly patients with newly diagnosed acute myeloid leukemia
| Predictive variables | n | No. of events | Univariate analysis | Multivariate analysisa | ||
|---|---|---|---|---|---|---|
| HR (95% CI) | P value | HR (95% CI) | P value | |||
| Age ≥ 80 | 96 | 36 | 1.80 (1.16‐2.80) | .009 | 1.88 (1.08‐3.30) | .027 |
| Sex (male) | 171 | 52 | 1.20 (0.76‐1.91) | .436 | ||
| Secondary AML | 94 | 31 | 1.27 (0.81‐1.99) | .307 | ||
| Therapy‐related AML | 25 | 10 | 1.59 (0.82‐3.09) | .169 | ||
| Antecedent hematologic disorder | 42 | 17 | 1.67 (0.98‐2.85) | .062 | 1.78 (0.96‐3.30) | .066 |
| AML‐MRC | 82 | 24 | 0.97 (0.60‐1.56) | .897 | ||
| APL | 11 | 2 | 0.58 (0.14‐2.36) | .446 | ||
| Comorbidities | ||||||
| Diabetes mellitus | 93 | 23 | 0.80 (0.49‐1.30) | .370 | ||
| Hypertension | 127 | 38 | 1.10 (0.71‐1.72) | .660 | ||
| Myocardial infarction | 54 | 21 | 1.60 (0.97‐2.64) | .065 | 1.87 (1.08‐3.24) | .025 |
| Ulcer disease | 45 | 17 | 1.58 (0.92‐2.71) | .094 | 1.21 (0.65‐2.24) | .553 |
| ECOG ≥ 2 | 116/270 | 46 | 2.73 (1.71‐4.38) | <.001 | 2.10 (1.22‐3.63) | .008 |
| Cytogenetics and molecular abnormalities | ||||||
| NPM1 | 20/125 | 2 | 0.39 (0.09‐1.64) | .199 | ||
| FLT3‐ITD | 18/125 | 4 | 1.11 (0.39‐3.22) | .841 | ||
| Complex karyotype | 58/263 | 22 | 1.90 (1.15‐3.14) | .013 | 3.21 (1.80‐5.71) | <.001 |
| Cytogenetics and molecular risk | ||||||
| Favorable | 36/263 | 7 | Reference | |||
| Intermediate | 133/263 | 36 | 1.44 (0.64‐3.25) | .374 | ||
| Poor/adverseb | 94/263 | 28 | 1.72 (0.75‐3.93) | .201 | ||
| Lab data | ||||||
| Bone marrow blasts ≥ 70% | 157/263 | 50 | 1.65 (1.00‐2.73) | .049 | 1.88 (1.07‐3.32) | .029 |
| Presence of blasts in peripheral blood | 182/275 | 59 | 1.47 (0.89‐2.44) | .135 | ||
| White blood cell count ≥ 100 K/µL | 26 | 15 | 3.19 (1.82‐5.62) | <.001 | 3.31 (1.59‐6.90) | .001 |
| Absolute neutrophil count < 500/µL | 82 | 19 | 0.72 (0.43‐1.20) | .209 | ||
| Hemoglobin < 10 g/dL | 231 | 63 | 0.76 (0.44‐1.31) | .320 | ||
| Platelets < 20 000/µL | 45 | 16 | 1.45 (0.84‐2.51) | .184 | ||
| eGFR < 45 | 63/274 | 30 | 2.71 (1.72‐4.28) | <.001 | 2.60 (1.54‐4.39) | <.001 |
Abbreviations: AML, acute myeloid leukemia; AML‐MRC, acute myeloid leukemia with myelodysplasia‐related changes; APL, acute promyelocytic leukemia; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group performance; eGFR, estimated Glomerular filtration rate; HR, hazard ratio.
a
All factors with P < .1 in the univariate analysis were included in the Cox multivariate analysis.
b
Poor/adverse risk was defined as complex (≥3 clonal chromosomal abnormalities), monosomal karyotype, −5, 5q‐, −7, 7q‐, 11q23 ‐ non t(9;11), inv(3), t(3;3), t(6;9), t(9;22), or FLT3‐ITD mutation with wild‐type NPM1.