title: Acute myelogenous leukaemia in older patients at St Bartholomew's Hospital: outcome with mitoxantrone and cytarabine.
abstract: Elderly patients (age >60 years) with AML who are selected for curative treatment frequently receive anthracycline/cytarabine containing regimens. The anthracendione mitoxantrone (MTN) in combination with cytarabine (Ara-C) produces comparable complete remission rates to other regimens and may be less toxic. Over a 12 year period, 75 patients (median age 67 years, range 60-83 years) referred with newly diagnosed AML were treated with MTN and ara-C. MTN was administered at 12 mg/m(2)/day intravenously for three days in the first 26 patients, and 10 mg/m(2)/day intravenously for five days in a subsequent 49 patients. Ara-C was administered at a dose of 100 mg/m(2) twice daily intravenously for seven days. Complete remission (CR) was achieved in 34 out of 75 patients (45%). The median disease-free survival overall was 7.5 months (one month to nine and a half years). The median survival was one year for patients in whom CR was achieved, compared to four months in patients whom treatment failed (P=0.001). Age alone was predictive of achievement of CR, whilst presentation karyotype, serum LDH and patient age correlated with overall survival. These results confirm that although elderly patients have a poor outcome, prognostic factors can be identified that influence treatment outcome in this important group of patients.
authors.affiliation: I.C.R.F. Medical Oncology Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK. cdalley@bcancer.bc.ca
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Dalley
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Lillington
authors.forename: Michael
authors.initials: M
authors.lastname: Bradburn
authors.forename: Maxine
authors.initials: M
authors.lastname: Carter
authors.forename: John A
authors.initials: JA
authors.lastname: Amess
authors.forename: Ama Z S
authors.initials: AZ
authors.lastname: Rohatiner
authors.forename: T Andrew
authors.initials: TA
authors.lastname: Lister
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D015415:Biomarkers / Q000097:blood; D002869:Chromosome Aberrations; D003561:Cytarabine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D011003:Ploidies; D011379:Prognosis; D012074:Remission Induction / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003561:Cytarabine; D008942:Mitoxantrone