title: Treatment of newly-diagnosed acute myelogenous leukaemia in patients aged 80 years and above.
abstract: In order to assess outcome following treatment of acute myeloid leukaemia (AML) in patients aged 80 years and above, we have studied 33 patients aged > or = 80 years treated between 1980 and 1994; 29 of these received treatment. The median age was 82 years (range 80-89). Three patients received daunorubicin ( > or = 60 mg/m2 daily x 3) alone or with low-dose ara-C, two patients received '3+7' with post treatment GM-CSF; 24 patients had higher doses of ara-C, generally with anthracyclines or fludarabine, and in nine cases with G or GM-CSF. The median survival of the treated patients was 3-4 weeks and only two were alive after 1 year (at 66 and 79 weeks). Complete remission (CR) occurred in 9/29 (31%). Only one of the nine remains alive in remission, at 76 weeks after the date of CR, whereas the other eight died in remission or had disease recurrence at a median of 11 weeks (range 5-37 weeks) after CR. The median survival of the four untreated patients was 10 weeks (range 3-38). Patients aged > or = 80 had, on average, worse outcomes than those observed in patients aged 70-79. Our results confirm that currently available chemotherapy is generally not indicated in patients aged 80 or over with AML.
authors.affiliation: Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: M
authors.initials: M
authors.lastname: DeLima
authors.forename: H
authors.initials: H
authors.lastname: Ghaddar
authors.forename: S
authors.initials: S
authors.lastname: Pierce
authors.forename: E
authors.initials: E
authors.lastname: Estey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D018447:Medical Futility; D011336:Probability; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003561:Cytarabine; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003630:Daunorubicin