title: Role of induction and consolidation chemotherapy in elderly acute myeloid leukemia patients.
abstract: The present study sought to elucidate the role of induction and consolidation therapy in elderly patients. We retrospectively collected data of 477 patients who were aged over 60 years at the time of acute myeloid leukemia (AML) diagnosis. The median overall survival (OS) was 339 days in the induction group (n = 266) and 86 days in the best supportive care group (n = 211) (P < 0.001). In the induction group, the complete remission (CR) rate was 58.3 %, and treatment-related death was 15.4 %. Successful induction was related to good performance [Eastern Cooperative Oncology Group (ECOG <2)] [hazard ratio (HR) 3.215; P = 0.002]. Mortality correlated with failure to achieve CR (HR 4.059; P < 0.001) and poor performance status (ECOG >2) (HR 2.731; P = 0.035). In CR patients, poor karyotype and absence of consolidation (HR 2.313; P = 0.003) correlated with mortality. More than one cycle of consolidation was associated with better OS (P < 0.001). Lack of salvage therapy was associated with mortality in patients who did not achieve CR (HR 3.223; P = 0.005). Intensive induction in patients with good performance and >1 cycle of consolidation after CR may be the best strategy for improving OS in elderly AML patients.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Kim
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.forename: Dae-Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyeong-Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Ik-Chan
authors.initials: IC
authors.lastname: Song
authors.forename: Deog-Yeon
authors.initials: DY
authors.lastname: Jo
authors.forename: Jeong-Ok
authors.initials: JO
authors.lastname: Lee
authors.forename: Soo-Mee
authors.initials: SM
authors.lastname: Bang
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Won-Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Young-Don
authors.initials: YD
authors.lastname: Joo
authors.forename: Chi Hoon
authors.initials: CH
authors.lastname: Maeng
authors.forename: Hwi-Joong
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Na-Ri
authors.initials: NR
authors.lastname: Lee
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.forename: Kyoung Ha
authors.initials: KH
authors.lastname: Kim
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Bo Ram
authors.initials: BR
authors.lastname: Han
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Zang
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Sung Hwa
authors.initials: SH
authors.lastname: Bae
authors.forename: Hun Mo
authors.initials: HM
authors.lastname: Ryoo
authors.forename: Sung-Yong
authors.initials: SY
authors.lastname: Kim
authors.forename: Mark Hong
authors.initials: MH
authors.lastname: Lee
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D060830:Consolidation Chemotherapy / Q000379:methods*; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D003561:Cytarabine; D014740:Vidarabine; C024352:fludarabine; D015255:Idarubicin; D003630:Daunorubicin