title: Adult acute leukaemia--a retrospective study of 66 consecutive patients.
abstract: BACKGROUND
  Advances in therapy and supportive care have improved the outlook for many patients with acute leukaemia, however elderly patients have increased treatment-related toxicity and shorter survival. Most clinical trials have selected patient populations with young median ages and it is therefore difficult to apply results to the general population where the majority of patients presenting with acute leukaemia are over 60 years. There is little information in the literature guiding appropriate treatment of these patients.
  
  
  OBJECTIVE
  To determine the relationship between age, treatment received, and outcome in patients presenting with acute leukaemia.
  
  
  METHODS
  A retrospective analysis was performed on all patients presenting to Prince Henry's Hospital and Monash Medical Centre with acute myeloid leukaemia (AML) or acute lymphocytic leukaemia (ALL) during a five year period.
  
  
  RESULTS
  Sixty-six patients (51-AML, 15-ALL) presented with acute leukaemia between March 1989 and April 1994. Median patient age was 63 years; 32% of patients received supportive therapy only; 86% of patients with ALL and 58% of patients with AML commencing remission-induction chemotherapy entered a complete remission. Median survival for patients receiving only supportive therapy was three months. Median survival in patients under 55 years was almost twice as long as patients over 55 years receiving similar treatment (AML-eight vs four months p = 0.023; ALL-3.5 vs seven months p = 0.029).
  
  
  CONCLUSIONS
  Median survival for acute leukaemia is inversely proportional to age. Applying results from selected series to elderly patients with acute leukaemia is inappropriate.
authors.affiliation: Department of Haematology and Medical Oncology, Monash Medical Centre, Melbourne, Vic.
authors.forename: J
authors.initials: J
authors.lastname: Shapiro
authors.forename: S
authors.initials: S
authors.lastname: Brown
authors.forename: P
authors.initials: P
authors.lastname: Briggs
authors.forename: R
authors.initials: R
authors.lastname: Stanley
authors.forename: J
authors.initials: J
authors.lastname: Griffiths
authors.forename: G
authors.initials: G
authors.lastname: Brodie
authors.forename: G
authors.initials: G
authors.lastname: Richardson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents