Prognostic factors in elderly patients with acute myelogenous leukemia: a single center study in Japan.
We retrospectively analyzed data of 47 patients aged 60 years or older, hospitalized in our institution with the diagnosis of acute myelogenous leukemia (AML), and searched for prognostic factors. Induction with anthracyclines significantly correlated with better complete remission (CR) rate (P = 0.0016) and overall survival (OS) (P < 0.001). Another factor significantly affecting CR rate was higher age (> 70 years) (P = 0.042). Therapy-non-related factors predictive for shorter OS in univariate analyses were age older than 70 years (P = 0.003), percentage of blasts in bone marrow more than 80% (P = 0.048), serum lactate dehydrogenase level higher than 250 U l(-1) (P = 0.032). In stepwise cox proportional hazard regression model, all the four factors predictive for poor OS remained to be independently and significantly prognostic for shorter OS. Only two patients receiving anthracyclines died within 30 days and the frequency was not different from that in patients not receiving anthracyclines. The use of anthracyclines as induction therapy is recommended even in the elderly patients.
Nannya
Yasuhito
Y
Department of Hematology, International Medical Center of Japan, Tokyo.
Kanda
Yoshinobu
Y
Oshima
Kumi
K
Kaneko
Makoto
M
Yamamoto
Rie
R
Chizuka
Aki
A
Hamaki
Tamae
T
Suguro
Miyuki
M
Matsuyama
Tomohiro
T
Takezako
Naoki
N
Miwa
Akiyoshi
A
Togawa
Atsushi
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D001752:Blast Crisis; D001854:Bone Marrow Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis
D018943:Anthracyclines; D007770:L-Lactate Dehydrogenase