title: Standard induction and low dose ara-C treatment in patients over 60 with AML or MDS.
abstract: In this retrospective study, 61 induction treatment periods in 57 patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) were evaluated. According to the WHO performance status, 6 patients received no chemotherapy, 20 had low dose cytosine arabinoside (LD ara-C) induction courses, and 35 received standard induction consisting of daunorubicin and cytosine arabinoside. Untreated patients had a poor survival. Of the 20 patients with LD ara-C induction courses, 4 (20%) achieved complete remission (CR). Three patients (15%) died during induction. Of 35 patients with standard induction, 21 patients (60%) achieved CR. Toxicity was considerable - 11 patients (31%) dying during treatment. We conclude that patients over 60 yr of age with RAEB, RAEB-t or AML had a CR rate and survival comparable to those of younger patients if treated with standard induction chemotherapy at the cost of serious therapy-related complications. In patients who were judged not to be able to tolerate standard induction and who were subsequently treated with LD ara-C, complications occurred less frequently, but the CR rate was low and survival short.
authors.forename: B M
authors.initials: BM
authors.lastname: van Geel
authors.forename: P C
authors.initials: PC
authors.lastname: Huijgens
authors.forename: G J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.forename: P W
authors.initials: PW
authors.lastname: Wijermans
authors.forename: M M
authors.initials: MM
authors.lastname: Langenhuijsen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D003561:Cytarabine; D003630:Daunorubicin