Objective: To investigate the survival and prognosis of acute myeloid leukemia (AML) in elderly patients with complications. Methods: The clinical characteristics and treatments of 55 newly diagnosed AML patients with complications at the age of ≥ 60 were analyzed retrospectively, to compare the efficacy and survival of three different induction regimens, including low-dose of MAG or CAG, standard-dose of DA or IA, and decitabine plus half-dose of CAG, and to compare the efficacy and expressions of CD34 and CD38, normal karyotype and abnormal karyotype. Results: (1) The survival time of the patients was prolonged significantly by chemotherapy than by palliative treatment. (2) There was no significant difference in the overall response rate among the three induction schemes of MAG or CAG, standard dose DA and decitabine plus half-dose of CAG. (3) There was no significant difference between the expression of CD34 and CD38, gene positive and chromosome karyotype in the overall survival of elderly patients. (4) Well-controlled complications such as hypertension, diabetes and so on had no obvious effect on the survival of the patients, but the total survival of the elderly patients with pulmonary infection decreased. Conclusion: Chemotherapy can improve the prognosis of elderly AML patients with senile complications, and the prognosis of these patients with pulmonary infection was poor. The expression of CD34 and CD38, and the genetic abnormalities have no significant effect on the overall survival of elderly AML patients with senile complications.
 LIM S H,DUBIELECKA P M,RAGHUNATHAN V M.Molecular targeting in acute myeloid leukemia[J].J Transl Med,2017,15(1):183.
 BELL J A,GALAZNIK A,HUELIN R,et al.Effectiveness and safety of therapeutic regimens for elderly patients with acute myeloid leukemia:a systematic literature review[J].Clin Lymphoma Myeloma Leuk,2018,18(7):e303-e314.
 LAURA F,ANDREW D,JAMES F,et al.Older patients with acute myeloid leukemia:treatment challenges and future directions[J].Ochsner J,2017,17(4):398-404.
 McCURDY S R,LEVIS M J.Emerging molecular predictive and prognostic factors in acute myeloid leukemia[J].Leuk Lymphoma,2018,59(9):2021-2039.
 SEKERES M A,ELSON P,KALAYCIO M E,et al.Time from diagnosis to treatment initiation predicts survival in younger,but not older,acute myeloid leukemia patients[J].Blood,2009,113(1):28-36.
 BERTOLI S,BERARD E,HUGUET F,et al.Time from diagnosis to intensive chemotherapy initiation does not adversely impact the outcome of patients with acute myeloid leukemia[J].Blood,2013,121(14):2618-2626.
 HERVE D,RAPHAEL I.How and when to decide between epigenetic therapy and chemotherapy in patients with AML[J].Hematology Am Soc Hematol Educ Program,2017,2017(1):45-53.
 LEY T J,DING L,WALTER M J,et al.DNMT3A mutations in acute myeloid leukemia[J].N Engl J Med,2010,363(25):2424-2433.
 DING L,LEY T J,LARSON D E,et al.Clonal evolution in relapsed acute myeloid leukaemia revealed by whole-genome sequencing[J].Nature,2012,481(7382):506-510.
 SHLUSH L I,MITCHELL A,HEISLER L,et al.Tracing the origins of relapse in acute myeloid leukaemia to stem cells[J].Nature,2017,547(7661):104-108.
 PAPAEMMANUIL E,GERSTUNG M,BULLINGER L,et al.Genomic classification and prognosis in acute myeloid leukemia[J].N Engl J Med,2016,374(23):2209-2221.