title: Conservative treatment for patients over 80 years with acute myelogenous leukemia.
abstract: In order to evaluate the best treatment of very elderly patients with AML, we have retrospectively analyzed 60 cases of patients aged more than 80 years, with a diagnosis of AML and observed from January 1988 to December 1998. Six of these patients were subsequently referred to other centers; of the remaining 54 patients, 20 (37%) received only supportive care, whereas 34 (63%) required palliative chemotherapy to control leukocytosis, after a median time from diagnosis of 9 days (range 0-253). Median overall survival was 13 weeks (range 1-105): 21 (39%) and 6 (11%) patients survived more than 6 and 12 months, respectively. Twenty-eight patients (51.8%) died from progressive disease, 19 (35.1%) died from AML-related or unrelated causes in the phase of stable disease, while in 7 patients the cause of death was unknown. In univariate analysis, PS > 2 and WBC > 50 x 10(9)/L had an adverse prognostic significance on survival. Our results, as compared with those reported in the literature for patients over 80 years treated with intensive chemotherapy, support the idea that intensive chemotherapy is usually not indicated in very elderly patients with AML, and that conservative treatment and the primary strategy of "watch-and-wait" presently seems to be the best choice.
authors.affiliation: Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza of Rome. rob.lati@libero.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
authors.forename: Ida
authors.initials: I
authors.lastname: Carmosino
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Paola Anticoli
authors.initials: PA
authors.lastname: Borza
authors.forename: Velia
authors.initials: V
authors.lastname: Bongarzoni
authors.forename: Carolina
authors.initials: C
authors.lastname: Copia
authors.forename: Antonio
authors.initials: A
authors.lastname: Spadea
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pinazzi
authors.forename: Natalia
authors.initials: N
authors.lastname: Frattarelli
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Petti
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents