title: The response to induction therapy is crucial for the treatment outcomes of elderly patients with acute myeloid leukemia: single-institution experience.
abstract: OBJECTIVE
  The prognosis of acute myeloid leukemia (AML) in elderly patients remains poor due to their poor general condition and the intrinsic chemotherapy-resistant nature of their leukemia cells. The present retrospective study evaluated the clinical background as well as the response to treatment, of an unselected group of elderly patients with AML who were admitted to our Institution over a period of six years.
  
  
  METHODS
  Patients aged 65 years or older with AML admitted to our Institution between January 2005 and May 2011 were evaluated retrospectively.
  
  
  RESULTS
  Forty-six patients were admitted to our Institution, among whom 41 received remission induction chemotherapy. Twenty-four patients received intensive chemotherapy, while 13 received low-dose cytarabine-based chemotherapy. Other modalities were used in four patients. Complete remission was obtained in 20 patients (48.8%). The complete remission rate (50.0%) tended to be higher in patients receiving intensive chemotherapy than in those receiving low-dose cytarabine-based regimens (30.7%; p=0.25). The median survival time for the whole patient group was 12 months and the 2-year overall survival was 18%. The median survival times for patients with complete remission and for non-responding patients were 14 months and 7 months, respectively. The 2-year overall survival in patients with complete remission was 32%, while that of non-responding patients was 6% (p=0.0025, log-rank test).
  
  
  CONCLUSIONS
  The present study suggests the necessity of achieving complete remission for obtaining better survival for elderly patients with AML.
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tasaki
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan tyamauch@u-fukui.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamauchi
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Takai
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Ookura
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Lee
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Tai
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikegaya
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kishi
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Urasaki
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Iwasaki
authors.affiliation: Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D016896:Treatment Outcome
keywords: AML; elderly; induction chemotherapy; prognosis