NONE PROMYELOCYTIC AML TREATED WITH IDA OR DNR OBSERVATION

To verify the superiority of idarubicin to daunorubicin in the field of respond on initial induction of none promyelocytic AML in the real world practices of Zhujiang hospital hematology department and investigate other clinical characteristics corelated with long term survive in these patients, the information of such patients who had at lest once of hospitalization in zhujiang hospital from Jan. 2019 to Sept. 2021 were collected. The complete remission rate of idarubicin included "3+7" regimen was significantly higher than that of daunorubicin included regimen after the initial induction. But the induction regimen was not independently corelated with induction remission. The cytogenetic risk classification and gender were the factors relating to remission with sitatistical significancy. The OS and PFS both significantly corelated with stem cell transplantation, meanwhile OS also significantly corelated with chemotherapy refractory feature. To those none favourable cytogenetic risk classified patients who had underwent transplantation, onset age was the only statistically independent factor corelated with OS, PFS and even time to relapse after transplantation. But we also found the initial induction regimen was another independent factor associated with relapse time after transplantation. The data told us in the real world practices, idarubicin induction was a better regimen to induct remission than daunorubicin in newly diagnosed none promyelocytic AML especially in the none favourable risk group or female group. But the long term survive of none promyelocytic AML more depended on later acceptance of transplantation or none chemotherapy refractory respondance. For those none favourable risk patients with transplantation, older onset age was still an unfavourable predictive factor to long term survive and idarubicin induction was a favourable predictive factor to postpone relapse after transplantation.为验证伊达比星（idarubicin）相较于柔红霉素（daunorubicin）在珠江医院血液内科真实世界实践中，针对非早幼粒细胞性急性髓系白血病（non-promyelocytic Acute Myeloid Leukemia, AML）初始诱导治疗的应答优势，并探究此类患者长期生存相关的其他临床特征，本研究收集了2019年1月至2021年9月期间于珠江医院至少住院1次的该类患者的临床资料。初始诱导治疗后，包含“3+7”方案的伊达比星治疗组的完全缓解率显著高于柔红霉素治疗组，但诱导治疗方案并非诱导缓解的独立相关因素。细胞遗传学风险分层与性别为具有统计学意义的缓解相关因素。总生存期（Overall Survival, OS）与无进展生存期（Progression-Free Survival, PFS）均与干细胞移植显著相关，同时OS亦与化疗难治性特征显著相关。对于接受移植的非良好细胞遗传学风险分层患者，发病年龄是与OS、PFS乃至移植后复发时间均相关的唯一统计学独立因素；但本研究同时发现，初始诱导治疗方案是与移植后复发时间相关的另一独立因素。本研究数据表明，在真实世界实践中，伊达比星诱导治疗相较于柔红霉素，在初诊非早幼粒细胞性AML患者中是更优的诱导缓解方案，尤其适用于非良好风险组或女性患者。但非早幼粒细胞性AML患者的长期生存更依赖于后期接受干细胞移植或非化疗难治性应答。对于接受移植的非良好风险患者，较高的发病年龄仍是长期生存的不良预后因素，而伊达比星诱导治疗则是延缓移植后复发的良好预后因素。