Acute myeloid leukemia in the elderly: conventional and novel treatment approaches.
Acute Myeloid Leukemia (AML) is a disorder affecting primarily elderly individuals and poses significant treatment challenges. Much has been learned about the underlying immunologic, cytogenetic and molecular features of AML in recent years, and many features have been identified that portend a poor prognosis for elderly patients with newly diagnosed AML. Despite this, treatment outcomes for elderly patients remain poor for both newly diagnosed and relapsed disease. While conventional treatment approaches may be appropriate for some elderly patients, the vast majority do not tolerate intensive chemotherapy well, thus alternative strategies have been investigated. Here we review both conventional and novel treatment approaches for elderly patients with AML, including agents in early clinical trials. Treatment options have been divided into several discussions, including conventional treatments, agents complementary to conventional treatments, alternatives to conventional induction therapies, post-induction treatment, and relapsed disease. Current and developing research focuses upon identifying subgroups of patients that benefit more from specific chemotherapeutic agents. Treating elderly patients with AML requires an organized, multidisciplinary approach, taking into account individual patient characteristics, preferences, and comorbidities when formulating treatment plans.
Craig
Chad M
CM
Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, CA, United States. ccraig@mednet.ucla.edu
Schiller
Gary J
GJ
D000227:Adenine Nucleotides / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001087:Arabinonucleosides / Q000627:therapeutic use; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use; D001374:Azacitidine / Q000627:therapeutic use; D000077866:Clofarabine; D003561:Cytarabine / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use; D015255:Idarubicin / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use; D012008:Recurrence; D013449:Sulfonamides / Q000627:therapeutic use
D000227:Adenine Nucleotides; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D001152:Arsenicals; D006834:Hydrazines; D010087:Oxides; D013449:Sulfonamides; D003561:Cytarabine; C483604:laromustine; D000077866:Clofarabine; D001374:Azacitidine; D000077237:Arsenic Trioxide; D015255:Idarubicin