title: Acute myeloid leukaemia in the elderly: a review.
abstract: The majority of patients with acute myeloid leukaemia (AML) are elderly. Advancements in supportive care and regimen intensification have resulted in improvements in clinical outcomes for younger AML patients, but analogous improvements in older patients have not been realized. While outcomes are compromised by increased comorbidities and susceptibility to toxicity from therapy, it is now recognized that elderly AML represents a biologically distinct disease that is more aggressive and less responsive to therapy. Some patients tolerate and benefit from intensive remission-induction approaches, while others are best managed with less aggressive strategies. The challenge is to differentiate these groups based on host-related and biological features, in order to maximize the therapeutic benefit and minimize toxicity. As more is understood about the complicated pathogenesis and molecular basis of AML, there are more opportunities to develop and test targeted therapies. Elderly patients, with their narrow therapeutic window, are well positioned to derive a benefit from these novel agents, and therefore, despite a difficult past, there are reasons to be optimistic about the future of elderly AML.
authors.affiliation: Divisions of Hematology and Oncology, Department of Internal Medicine, University Cancer Center, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305, USA. dpollyea@stanford.edu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Pollyea
authors.forename: Holbrook E
authors.initials: HE
authors.lastname: Kohrt
authors.forename: Bruno C
authors.initials: BC
authors.lastname: Medeiros
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents