老年人急性髓系白血病的治疗和预后因素

 急性髓系白血病（AML）主要见于老年人，老年人AML发病率疗效差且无公认的治疗策略。老年人AML的治疗，诱导缓解应在诊断后尽早开始，尽可能达到完全缓解（CR）。诱导治疗方案可根据患者一般状况、器官功能、年龄而选择标准化疗、小剂量阿糖胞苷化疗及支持治疗。缓解后需要巩固治疗，巩固治疗以三个疗程为宜，巩固治疗的强度以中剂量阿糖胞苷为宜。维持治疗对预后不良者可能有效。年龄和染色体核型是老年人AML重要的预后因素，结合患者一般状况器官功能确定个体化治疗方案，有可能提高老年人AML的疗效。

The treatment and prognositic factors of elderly patients with acute myeloid leukemia

AML is mainly a disease of elderly people，the prognosis of AML in the elderly was poor and what are the best therapeutic options for eldly patients with AML is still unanswered. Induction chemotherapy should be started without delay, standard dose chemotherapy, low dose cytarabine or palliative should been chosen dependent on the patient's performance status, organ function and age. Consolidation chemotherapy should be needed for older patients with AML after achieving CR and should been given no more than three courses. Maintanance chemotherapy may be needed only for high-risk older patients with AML. Cytogenetics and age are major prognostic factors for AML in the elderly.