title: High-Intensity Induction Chemotherapy Is Feasible for Elderly Patients with Acute Myeloid Leukemia.
abstract: BACKGROUND
  The prognosis of elderly patients with acute myeloid leukemia (AML) is poor, and the best treatment is controversial. Since the majority of AML patients are older than 60 years, identification of those who might benefit from intensive treatment is essential.
  
  
  METHODS
  Data from electronic charts of consecutive AML patients treated in our center were analyzed. Eligibility criteria included newly diagnosed de novo or secondary AML, an age of 60 years or older, and intensive induction treatment.
  
  
  RESULTS
  Sixty-two patients were included in the analysis. Forty-six patients (74%) achieved complete remission (CR) after 1-2 intensive induction courses. Twenty of them received consolidation with conventional chemotherapy, 20 proceeded to allogeneic hematopoietic cell transplantation (allo-HCT), and 6 were ineligible for further treatment. The projected overall survival (OS) at 2 and 3 years was 28 and 23%, respectively. A normal karyotype, CR achievement, and allo-HCT were associated with improved OS, while an Eastern Cooperative Oncology Group performance status of 0-1 was borderline associated. The median survival and disease-free survival at 2 years was 18.7 months and 49%, respectively, for patients who underwent allo-HCT in CR1, compared to 12.8 months and 25%, respectively, for those who did not.
  
  
  CONCLUSIONS
  Based on our data, selected eligible elderly AML patients might benefit from intensive treatment.
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Shacham-Abulafia
authors.forename: Gilad
authors.initials: G
authors.lastname: Itchaki
authors.forename: Moshe
authors.initials: M
authors.lastname: Yeshurun
authors.forename: Mical
authors.initials: M
authors.lastname: Paul
authors.forename: Anat
authors.initials: A
authors.lastname: Peck
authors.forename: Avi
authors.initials: A
authors.lastname: Leader
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
authors.forename: Ron
authors.initials: R
authors.lastname: Ram
authors.forename: Pia
authors.initials: P
authors.lastname: Raanani
mesh_terms: D000368:Aged; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate