title: Treatment patterns and comparative effectiveness in elderly acute myeloid leukemia patients (age 70 years or older): the Lyon-university hospital experience.
abstract: The treatment of very elderly patients (≥70 years) with acute myeloid leukemia remains controversial. We present here 302 patients seen over a 14-year period in order to understand the real-world treatment patterns and outcomes in this patient population. Less than 25% of patients achieved a complete remission. The median overall survival was 12.4, 11.5 and 2.6 months, with a 3-year rates of 27%, 17% and 6%, for non-acute promyelocytic leukemia patients receiving intensive chemotherapy, lower-intensity therapy or best supportive care (BSC), respectively. In all ages, results were not significantly different among patients receiving low-intensity therapy and intensive chemotherapy, but significantly worse in those treated with BSC only. Similarly, intensive chemotherapy and low-intensity therapy gave better survival rates than BSC in patients with favorable- or intermediate-risk cytogenetics and in those with unfavorable cytogenetics (p < 0.0001 and p = 0.04, respectively).
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Maël
authors.initials: M
authors.lastname: Heiblig
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Le Jeune
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elhamri
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Marie
authors.initials: M
authors.lastname: Balsat
authors.affiliation: b Laboratory of Cytogenetics , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tigaud
authors.affiliation: c Laboratory of Cytology and Immunology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Adriana
authors.initials: A
authors.lastname: Plesa
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Barraco
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Labussière
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ducastelle
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Franck
authors.initials: F
authors.lastname: Nicolini
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Wattel
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Salles
authors.affiliation: a Department of Hematology , Lyon-Sud Hospital, Hospices Civils de Lyon , Pierre Bénite , France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Acute myeloid leukemia; elderly; prognosis; treatment