Prognosis of elderly patients with acute myelogenous leukemia: analysis of 126 AML cases.
We retrospectively analyzed 126 acute myelogenous leukemia (AML) patients aged > or =60 years who had all been referred to the same hematological department between 1989 and 1999. In 76 de novo AML cases, 53 patients (median age, 72 years) were treated with combination chemotherapy (CT) for remission induction. Complete remission (CR) rate was 57.1%. The median overall survival (OS) was 16 months, and the rate of 3-year OS was 28%. The favorable prognostic factors were performance status < or =2, cholinesterase > or =100 IU, and intermediate or favorable karyotype (P < .01). Seventeen patients (median age, 78 years) with hypocellular bone marrow or poor general condition were treated with low-dose cytosine arabinoside (LDAraC). In these patients, the CR rate was 50% and the median OS was 11 months, with an OS estimate at 3 years of 14%. All patients with hypocellular bone marrow who received LDAraC for 21 days achieved CR. In 50 patients who developed AML following a myelodysplastic syndrome (MDS/AML), 22 patients (median age, 74 years) were treated with CT, and 14 (median age, 74 years) patients were treated with LDAraC. The CR rates were 22.7% and 21.4%, respectively, and the median OS durations were 8 months and 11 months, respectively. There were no significant factors that would indicate a good prognosis in MDS/AML patients.
Iwakiri
Rika
R
Department of Hematology, Tokyo Metropolitan Geriatric Hospital, Japan.
Ohta
Masatsugu
M
Mikoshiba
Michiaki
M
Tsutsumi
Hisashi
H
Kumakawa
Toshiro
T
Mori
Mayumi
M
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002802:Cholinesterases / Q000097:blood; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003630:Daunorubicin / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000401:mortality*; D015993:Life Tables; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000453:epidemiology; D009363:Neoplasm Proteins / Q000097:blood; D011379:Prognosis; D012074:Remission Induction; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate
D000964:Antimetabolites, Antineoplastic; D009363:Neoplasm Proteins; D003561:Cytarabine; D000493:Allopurinol; C015019:enocitabine; D015122:Mercaptopurine; D002802:Cholinesterases; D003630:Daunorubicin