Treatment concepts for elderly patients with acute myeloid leukemia.
The majority of patients with acute myeloid leukemia (AML) are over 60 years of age at diagnosis. Unlike treatment options for younger adults, those for older patients are limited to non-myeloablative therapy, and many patients are not treatable because of poor performance status. In those who are treatable, long-term survival can be achieved using intensive induction and consolidation chemotherapy. Such curative treatment can be administered in about 70% of elderly patients with AML. In responding patients (up to 60%) the disease-free survival may be almost comparable to that of younger adults. However, treatment-related toxicity results in a higher mortality rate in the elderly patients. Moreover, aggressive chemotherapy cannot be used for 30% of the patients, due to their poor performance status. Currently, palliative cytoreductive treatment and supportive care are considered appropriate for these patients. Recently, however, targeting antileukemic antibodies and inhibitors of signal transduction have been introduced as promising new treatment options. The therapeutic efficiency and toxicity-profiles of these novel drugs are currently under investigation in clinical trials.
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000627:therapeutic use; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D013866:Thioguanine / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D005047:Etoposide; D013866:Thioguanine; D015255:Idarubicin