title: Acute Myelogenous Leukaemia in Patients 60 Years and Older: A Retrospective Analysis from St Bartholomew's Hospital 1969-1999.
abstract: Between 1969 and 1999, 420 patients (age > 60 years) with newly diagnosed AML were managed at St Bartholomew's Hospital (SBH), London, UK. Sixty-nine percent of patients received therapy with curative intent Eighty-eight patients (31%) of the latter achieved complete remission (CR), representing an overall CR rate of 21%. Treatment failure due to early death (ED) and resistant disease (RD) occurred in 50 and 19%, respectively. With median follow up of 11 years, actuarial survivals at 1,3 and 5 years were 20, 7 and 4%, respectively, the median survival of the entire cohort was 2 months. For patients who achieved CR, median survival was significantly better than that of patients in whom treatment failed (14 vs. 6 months). Over the 30 years, CR rate and the relative incidence of RD both increased from 13 to 45%, and 3 to 27%, respectively, whilst ED rate reduced from 84 to 27%. Multivariate analysis showed that treatment era, hepatosplenomegaly and increasing age predicted for reduced CR rate and OS. Although elderly patients with AML are characterised by a poor response to intensive chemotherapy, significant improvements in supportive care and the delivery of intensive treatment have led to improved CR rates and OS. New therapeutic strategies and a greater awareness of prognostic factors may further improve clinical outcome in this important group of patients.
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.|b Department of Haematology St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Dalley
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Rohatiner
authors.affiliation: c I.C.R.F Medical Statistics Group , Institute of Health Sciences , Headington, Oxford , OX3 7LF , UK.
authors.forename: M
authors.initials: M
authors.lastname: Bradburn
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Lillington
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: M
authors.initials: M
authors.lastname: Carter
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: S
authors.initials: S
authors.lastname: Slater
authors.affiliation: b Department of Haematology St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: P
authors.initials: P
authors.lastname: MacCallum
authors.affiliation: b Department of Haematology St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Amess
authors.affiliation: a I.C.R.F Medical Oncology Unit , St Bartholomew's Hospital West Smithfield , London , EC1A 7BE , UK.
authors.forename: T A
authors.initials: TA
authors.lastname: Lister
keywords: Acute myelogenous leukaemia; Chemotherapy; Complete remission; Cytogenetics; Elderly