Treatment of elderly patients with acute myeloid leukemia adjusted for performance status and presence of comorbidities: a Polish Adult Leukemia Group study.
This prospective study estimated outcomes in 509 elderly patients with acute myeloid leukemia (AML) with different treatment approaches depending on Eastern Cooperative Oncology Group (ECOG) performance status and Charlson Comorbidity Index (CCI). Patients were stratified into fit (ECOG 0-2 and CCI 0-2) or frail (ECOG>2 and/or CCI>2) groups. Fit patients with CCI 0 received intensive chemotherapy whilst reduced-intensive chemotherapy (R-IC) was given to those with CCI 1-2. Frail patients received best supportive therapy. Fit patients presented a longer overall survival (OS) than frail subjects, but 8-week mortality rates were similar. The complete response (CR) rate between fit CCI 0 and CCI 1-2 subgroups was significantly different. Both of the fit subgroups showed similar 8-week mortality rates and OS probabilities. Allocating fit patients with CCI 1-2 to R-IC enabled an increase in the group of elderly patients who could be treated with the intention of inducing remission.
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.|b Center of Postgraduate Medical Education , Warsaw , Poland.
Bozena Katarzyna
BK
Budziszewska
c Hematology Department, Medical University of Lodz , Lodz , Poland.
Agnieszka
A
Pluta
d Hematology Department, Military Medical Institute , Warsaw , Poland.
Kazimierz
K
Sulek
c Hematology Department, Medical University of Lodz , Lodz , Poland.
Agnieszka
A
Wierzbowska
c Hematology Department, Medical University of Lodz , Lodz , Poland.
Tadeusz
T
Robak
e Department of Bone Marrow Transplantation , Comprehensive Cancer Center, M. Sklodowska-Curie Memorial Institute , Gliwice , Poland.
Sebastian
S
Giebel
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
Aleksandra
A
Holowiecka-Goral
d Hematology Department, Military Medical Institute , Warsaw , Poland.
Waldemar
W
Sawicki
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
Anna
A
Ejduk
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.|b Center of Postgraduate Medical Education , Warsaw , Poland.
Elzbieta
E
Patkowska
f Hematology Department, Medical University of Lublin , Lublin , Poland.
Joanna
J
Manko
g Hematology Department, Nicolaus Copernicus Hospital , Torun , Poland.
Justyna
J
Gajkowska-Kulik
h Hematology Department, Medical University of Bialystok , Bialystok , Poland.
Jaroslaw
J
Piszcz
i Lower Silesian Centrum for Cellular Transplantation , Wroclaw , Poland.
Monika
M
Mordak-Domagala
j Hematology and Oncology Department, Warsaw Medical University , Warsaw , Poland.
Krzysztof
K
Madry
e Department of Bone Marrow Transplantation , Comprehensive Cancer Center, M. Sklodowska-Curie Memorial Institute , Gliwice , Poland.
Jerzy
J
Holowiecki
k Hematology Department and BMT , Medical University of Silesia , Katowice , Poland.
Slawomira
S
Kyrcz-Krzemien
l Hematology Department, Center of Oncology , Kielce , Poland.
Maria
M
Nowakowska-Domagala
f Hematology Department, Medical University of Lublin , Lublin , Poland.
Anna
A
Dmoszynska
g Hematology Department, Nicolaus Copernicus Hospital , Torun , Poland.
Malgorzata
M
Calbecka
h Hematology Department, Medical University of Bialystok , Bialystok , Poland.
Janusz
J
Kloczko
j Hematology and Oncology Department, Warsaw Medical University , Warsaw , Poland.
Wiesław
W
Wiktor Jędrzejczak
i Lower Silesian Centrum for Cellular Transplantation , Wroclaw , Poland.
Andrzej
A
Lange
m Hematology Department, Rydygier Memorial Hospital , Krakow , Poland.
Malgorzata
M
Razny
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
Przemyslaw
P
Bilinski
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
Krzysztof
K
Warzocha
a Hematology Department, Institute of Hematology and Transfusion Medicine , Warsaw , Poland.|b Center of Postgraduate Medical Education , Warsaw , Poland.
Ewa
E
Lech-Maranda
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
Acute myeloid leukemia; comorbidities; performance status; treatment