ABSTRACT
Objective: To evaluate the prognostic significance of comprehensive geriatric assessment (CGA) in Chinese elderly acute myeloid leukemia (AML) patients. Methods: 73 AML patients over the age of 60 were enrolled. CGA stratification included the following 3 instrument assessment: activity of daily living (ADL) ; instrumental activity of daily living (IADL) ; comorbidity score according to the Modified cumulative illness rating score for geriatrics (MCIRS-G) . According to CGA and age, the enrolled patients were grouped into 'fit', 'unfit' and 'frail' categories. Results: The median age of 73 elderly AML patients were 75 years old. According to CGA, 37 (50.1%) patients were classified as 'fit', 14 (19.2%) as 'unfit', and 22 (30.7%) as 'frail'. 33 (89.2%) patients in fit group received induction chemotherapy, or demethylation treatment, as 8 (57.9%) in unfit, 10 (45.5%) in frail. The overall response rate was 68.7%ã62.5%, 75.0% in fit, unfit, and frail group, respectively (χ(2)=0.615, P=0.769) .The early mortality (8 weeks) in three groups were different: 5.4%, 7.1%, 27.3%, respectively (P<0.05) . The 1-year overall survival in the 'fit', 'unfit' and 'frail' groups was 64.9%, 28.6% and 22.7%, respectively (P<0.05) . The CGA score, age, ECOG score, WHO classification (2016) were the prognostic factors of AML patients. Conclusion: CGA can be used to determine the prognosis of elderly AML patients.
Subject(s)
Geriatric Assessment , Leukemia, Myeloid, Acute , Aged , Comorbidity , Humans , PrognosisABSTRACT
OBJECTIVE: To estimate the prevalence of anemia in urban community dwelling elderly population. METHODS: This study was a cross-sectional survey of prevalence of anemia in randomly selected community dwelling residents aged over 65 years in Beijing. Anemia was defined as hemoglobin concentration less than 130 g/L in men and 120 g/L in women. RESULTS: The hemoglobin concentration was (135.65±14.48) g/L in total of 1 947 eligible participants and was much higher in men than in women [(142.56±15.56) g/L vs (130.95±11.53) g/L, P<0.001]. There were 288 (14.8%) patients with anemia, including 16.3%(129/789) in men and 13.7%(159/1 158) in women. The prevalence of anemia increased significantly with age, which was 7.6% in 65-69 years, 10.8% in 70-74 years, 18.8% in 75-79 years and 24.1% over 80 years (P<0.001). Two hundred and seventy-nine (96.9%) subjects were mild anemia, 8 (2.8%) moderate, only 1 subject (0.3%) severe. Unexplained anemia was predominant, which accounted for 63.2%. Only 16.7% people were diagnosed as nutritional anemia, renal anemia 5.2%, anemia of chronic disease (ACD) 12.2%. There were 2.4% people with overlapped renal anemia and ACD. Compared with non-anemic subjects, more subjects with unexplained anemia represented macrocytosis (7.1% vs 3.2%, P=0.007). CONCLUSIONS: Anemia is a common health problem in urban community dwelling elderly population. Most subjects have anemia with unknown origin. Further investigation is needed to explore the mechanism and related factors of elderly anemia.
