PB1760 CHARACTERISTICS OF DIAGNOSIS AND TREATMENT OUTCOME IN PATIENTS WITH ACUTE MYELOID LEUKEMIA OLDER THAN 60 YEARS‐ANALYSES OF SINGLE CENTER

Background: Patients with acute myeloid leukemia older than 60 years old have a poor prognosis and frequently are not fit for standard chemotherapy. Aims: We retrospectively analysed diagnosis characteristics and treatment outcome in order to identify particularities present in elderly acute myeloid leukemia (AML) group. Methods: We enrolled 62 AML patients older than 60 years diagnosed in Hematology Department Colentina Clinical Hospital between 2015‐2019. The diagnosis of AML was made according to French‐American‐British Cooperative Group (FAB) classification combined with the 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia. Results: The median age was 70 years (range 72 to 76 years), and the male:female ratio was 1:1.The most frequent AML subtype was AML1 – 29 cases (46,77%) and in many cases AML was secondary myelodisplastic syndrome evolution – 38 cases (61%) Analysis of evolution data revealed an AML subgroup, consisting of 28 newly diagnosed patients, with a particular short survival – less than 2 months. Eleven patients from this subgroup were not treated due infection presence at diagnosis, this complication has negative influence of evolution of AML patients. In 17 patients we started treatment with hypomethylating agents (Azacytidina or Decytabina) and in 3 patients Mercaptopurine. The treatment outcome analysis identified 16 AML patients with unfavourable evolution due infection associated with severe neutropenia; 1 patient was lost due disease progression. Molecular diagnosis revealed FLT3‐ITD mutation in 4 patients, 3 of them being lost immediately after diagnosis (1‐2 moths). Cytogenetic results were available for 35 AML patients. The majority of patients had complex karyotype changes or other adverse or intermediate risk cytogenetics (25 out of 35 patients). The analyses of survival rate was performed by Kaplan Meier statistic method and used as endpoint the death and as analyses factors: the progression risk, treatment, presence of pancytopenia, infection. We obtained significant difference in patients group older than 75 years old who have infection – median survival rate 1 months (95%CI 1‐8 mo) compared with those without infection 21 months (9‐27mo), p = 0.05 Summary/Conclusion: Acute myeloid leukemia diagnosed in our patients group was frequently secondary to MDS. Intermediate and high risk cytogenetic abnormalities were detected in a majority of these patients. Infection represent an important unfavourable factor in evolution and treatment outcome of patient older than 75 years