Non-transplant therapy for older adults with acute myeloid leukemia.
Acute myeloid leukemia is a disease of older adults, with a median age at diagnosis of 68 years. This group represents a high-risk population, because inherent disease characteristics predict for resistance to chemotherapy and advanced age is accompanied by high treatment-related mortality. Standard remission-induction and postremission therapy can result in a median disease-free survival of 10 months and rare long-term survival. Efforts to improve outcomes have not made a major impact on complete remission rates of 40% to 60%, or on overall survival. Newer therapies, divided into aggressive and nonaggressive approaches, focus on targeting the disease biology specific to older adults and on maximizing quality of life. Clinical trials should be considered at every stage of treatment in this group of patients.
Sekeres
Mikkael A
MA
Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk R35, Cleveland, OH 44195, USA. sekerem@ccf.org
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D020732:Cytogenetic Analysis; D000079982:Gemtuzumab; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D015363:Quinolones / Q000627:therapeutic use
D000617:Aminoglycosides; D000903:Antibiotics, Antineoplastic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D015363:Quinolones; D003561:Cytarabine; D000079982:Gemtuzumab; C402769:tipifarnib