Therapeutic outcomes of older patients with acute myeloid leukemia.
OBJECTIVE
To evaluate the therapeutic outcomes of acute myeloid leukemia (AML) in elderly patients.


METHODS
This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan over 11 years from January 1997 to August 2008. This was a descriptive case series study. We investigated the impact of disease biology and various treatment protocols on the outcome in this population.


RESULTS
A total of 55 evaluable patients (>60 years of age) were diagnosed with AML including 34 (61.8%) males and 21 (38.2%) females. The median age was 67 years (range 60-86 years) at the time of presentation. The AML was preceded by myelodysplastic syndrome in 15 (27.2%) patients. High-risk cytogenetics were observed in 3 (5.4%) patients. Forty patients received palliative treatment while only 15 received chemotherapy. Of the last group with primary AML (n=10), there were 2 remitters, one showed resistant disease while 8 had induction death. The overall mean survival was 75.1 days (95% confidence interval: 46.7-103.5 days) in all patients. There was no survival advantage in patients treated with chemotherapy versus those conservatively treated.


CONCLUSIONS
We found high mortality among aged patients with AML in our setting. Patients receiving chemotherapy were extremely intolerant to toxic drugs and succumbed earlier than patients receiving palliative care only.
Sajid
Raihan
R
Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi 74800, Pakistan. raihan.sajid@aku.edu
Moiz
Bushra
B
Ali
Natasha
N
Kamran
Nausheen
N
Adil
Adil N
AN
Shaikh
Usman
U
Khurshid
Mohammad
M
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome